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Diagnostic Performance of Multi-Direction Adjusted Multi-Planar Reconstruction with Helical CT for Evaluating Continuity of the Anterior Cruciate Ligament

Published:March 01, 2022DOI:https://doi.org/10.1016/j.acra.2021.12.031

      Highlights

      • Key findings By applying multi-direction adjusted multi-planar reconstruction (MDA-MPR) to CT images, we demonstrated its diagnostic value in evaluating anterior cruciate (ACL) ligament injuries. The power of this technology is that the full-length ligament may be viewed on a single imaging plane, thereby allowing for easy assessment of structural continuity.
      • Importance: MDA-MPR with CT provides a non-invasive alternative to standard approaches used in ACL injury assessment with notable sensitivity and specificity for complete ACL tears.

      Rationale and Objectives

      To analyze the diagnostic performance of MDA-MPR with CT for evaluating ACL structural continuity.

      Methods

      A total of 145 patients with highly suspected ACL injury admitted to our hospital between January 2016 and May 2021 were retrospectively enrolled. All patients had undergone examination with MRI, CT, and arthroscopy. Taking arthroscopy results as the gold standard, the diagnostic accuracy for identifying ACL rupture by MRI and MDA-MPR with CT were compared.

      Results

      The receiver operator characteristic curves demonstrated that both MRI and MDA-MPR with CT performed well in the diagnosis of ACL tears. The sensitivities of MRI and MDA-MPR with CT for diagnosing complete ACL tears were 95.16% (59/62) and 90.32% (56/62), respectively. Their specificities in this regard were 77.11% (64/83) and 84.34% (70/83), respectively. MRI had a higher sensitivity but MDA-MPR with CT had a higher specificity for detecting complete ACL tears, and the differences were statistically significant (p <.05). The sensitivities of diagnosing partial ACL tears using MRI and MDA-MPR with CT were 78.79% (26/33) and 75.76% (25/33), respectively, while the specificities were 86.61% (97/112) and 90.18% (101/112), respectively. These differences were non-significant (p >.05).

      Conclusion

      MDA-MPR with CT has high diagnostic efficiency for ACL injuries, especially in the diagnosis of complete ACL tears.

      Key Words

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      REFERENCES

        • Gandolfi M
        • Ricci M
        • Sambugaro E
        • et al.
        Changes in the sensorimotor system and semitendinosus muscle morphometry after arthroscopic anterior cruciate ligament reconstruction: a prospective cohort study with 1-year follow-up. Knee surgery, sports traumatology.
        Arthroscopy : Official J ESSKA. 2018; 26: 3770-3779
        • Barton K
        • Shekarforoush M
        • Heard B
        • et al.
        Three-dimensional in vivo kinematics and finite helical axis variables of the ovine stifle joint following partial anterior cruciate ligament transection.
        J Biomech. 2019; 88: 78-87
        • Hagmeijer M
        • Hevesi M
        • Desai V
        • et al.
        Secondary meniscal tears in patients with anterior cruciate ligament injury: relationship among operative management, osteoarthritis, and arthroplasty at 18-year mean follow-up.
        Am J Sports Med. 2019; 47: 1583-1590
        • Murrell G
        • Maddali S
        • Horovitz L
        • Oakley S
        • Warren R
        The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss.
        Am JSports Med. 2001; 29: 9-14
        • Pedersen M
        • Johnson J
        • Grindem H
        • Magnusson K
        • Snyder-Mackler L
        • Risberg M
        Meniscus or cartilage injury at the time of anterior cruciate ligament tear is associated with worse prognosis for patient-reported outcome 2 to 10 years after anterior cruciate ligament injury: a systematic review.
        J Orthop Sports Phys Ther. 2020; 50: 490-502
        • Kay J
        • Memon M
        • Shah A
        • et al.
        Earlier anterior cruciate ligament reconstruction is associated with a decreased risk of medial meniscal and articular cartilage damage in children and adolescents: a systematic review and meta-analysis. Knee surgery, sports traumatology.
        Arthroscopy : Official 1 ESSKA. 2018; 26: 3738-3753
        • Lee Y
        • Lee O
        • Lee S
        • Hui T
        Effect of the timing of anterior cruciate ligament reconstruction on clinical and stability outcomes: a systematic review and meta-analysis.
        Arthroscopy : J Arthrosc Rela Surg. 2018; 34: 592-602
        • Muhle C
        • Ahn J
        • Dieke C
        Diagnosis of ACL and meniscal injuries: MR imaging of knee flexion vs extension compared to arthroscopy.
        SpringerPlus. 2013; 2: 213
        • Jog A
        • Smith T
        • Pipitone P
        • Toorkey B
        • Morgan C
        • Bartolozzi A
        Is a partial anterior cruciate ligament tear truly partial? a clinical, arthroscopic, and histologic Investigation.
        Arthroscopy : J ArthroscRela Surg. 2020; 36: 1706-1713
        • Dutka J
        • Skowronek M
        • Skowronek P
        • Dutka L
        Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study.
        Wideochirurgia i inne techniki maloinwazyjne = Videosurg Other Miniinvasive Tech. 2012; 7: 13-18
        • Saithna A
        • Monaco E
        • Muramatsu K
        • et al.
        Regarding "identification of normal and injured anterolateral ligaments of the knee: a systematic review of magnetic resonance imaging studies".
        Arthroscopy : J ArthroscRela Surg. 2019; 35: 2257-2258
        • Kosy J
        • Schranz P
        • Patel A
        • Anaspure R
        • Mandalia V
        The magnetic resonance imaging appearance of the anterolateral ligament of the knee in association with anterior cruciate rupture.
        Skeletal Radiol. 2017; 46: 1193-1200
        • Greif D
        • Baraga M
        • Rizzo M
        • et al.
        MRI appearance of the different meniscal ramp lesion types, with clinical and arthroscopic correlation.
        Skeletal Radiol. 2020; 49: 677-689
        • Vassalou E
        • Klontzas M
        • Kouvidis G
        • Matalliotaki P
        • Karantanas A
        Rotational knee laxity in anterior cruciate ligament deficiency: an additional secondary sign on MRI.
        AJR Am J Roentgenol. 2016; 206: 151-154
        • Dejour D
        • Ntagiopoulos P
        • Saggin P
        • Panisset J
        The diagnostic value of clinical tests, magnetic resonance imaging, and instrumented laxity in the differentiation of complete versus partial anterior cruciate ligament tears.
        Arthroscopy : J ArthroscRela surg. 2013; 29: 491-499
        • McIntyre J
        • Moelleken S
        • Tirman P
        Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears.
        Skeletal Radiol. 2001; 30: 312-315
        • Van Dyck P
        • De Smet E
        • Veryser J
        • et al.
        Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging.
        Knee SurgSports Traumatol Arthrosco : Official J ESSKA. 2012; 20: 256-261
        • Vande Berg B
        • Lecouvet F
        • Poilvache P
        • et al.
        Dual-detector spiral CT arthrography of the knee: accuracy for detection of meniscal abnormalities and unstable meniscal tears.
        Radiology. 2000; 216: 851-857
        • Lee W
        • Kim H
        • Kim S
        • et al.
        CT arthrography and virtual arthroscopy in the diagnosis of the anterior cruciate ligament and meniscal abnormalities of the knee joint.
        Korean J Radiol. 2004; 5: 47-54
        • Liu Y
        • Sun J
        • Guo Y
        • Lu Q
        • Zhao D
        • Lin Y
        Quality assessment of 3D-CTVR, MPR and section plane techniques in ossicular chain reconstruction in middle ear cholesteatoma. Computerized medical imaging and graphics : the official journal of the.
        Comput Med Imaging Soc. 2014; 38: 696-701
        • Chen Y
        • Zhang K
        • Xu Y
        • Che Y
        • Guan L
        • Li Y
        Reliability of temporal bone high-resolution CT in patients with facial paralysis in temporal bone fracture.
        Am J Otolaryngol. 2018; 39: 150-152
        • Dankerl P
        • Seuss H
        • Ellmann S
        • Cavallaro A
        • Uder M
        • Hammon M
        Evaluation of Rib Fractures on a Single-in-plane Image Reformation of the Rib Cage in CT Examinations.
        Acad Radiol. 2017; 24: 153-159
        • Shizukuishi T
        • Abe K
        • Takahashi M
        • et al.
        Inguinal bladder hernia: multi-planar reformation and 3-D reconstruction computed tomography images useful for diagnosis.
        Nephrology (Carlton, Vic). 2009; 14: 263
        • Anderson A
        • Dome D
        • Gautam S
        • Awh M
        • Rennirt G
        Correlation of anthropometric measurements, strength, anterior cruciate ligament size, and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates.
        Am J Sports Med. 2001; 29: 58-66
        • Mengou Z
        • Ying Z
        • Junru C
        • et al.
        The accuracy of MRI in the diagnosis of anterior cruciate ligament injury.
        Ann Trans Med. 2020; 8: 1657-1663
        • Thomas S
        • Pullagura M
        • Robinson E
        • Cohen A
        • Banaszkiewicz P
        The value of magnetic resonance imaging in our current management of ACL and meniscal injuries.
        Knee SurgSports TraumatolArthrosy : Official J ESSKA. 2007; 15: 533-536
        • Duc S
        • Pfirrmann C
        • Koch P
        • Zanetti M
        • Hodler J
        Internal knee derangement assessed with 3-minute three-dimensional isovoxel true FISP MR sequence: preliminary study.
        Radiology. 2008; 246: 526-535
        • Nagai T
        • Bates N
        • Hewett T
        • Schilaty N
        Effects of localized vibration on knee joint position sense in individuals with anterior cruciate ligament reconstruction.
        Clin Biomech (Bristol, Avon). 2018; 55: 40-44
        • Jin C
        • Song E
        • Jin Q
        • Lee N
        • Seon J
        Outcomes of simultaneous high tibial osteotomy and anterior cruciate ligament reconstruction in anterior cruciate ligament deficient knee with osteoarthritis.
        BMC Musculoskeletal Disord. 2018; 19: 228
        • Orlando Júnior N
        • de Souza Leão M
        • de Oliveira N
        Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy.
        Rev Bras De Ortop. 2015; 50: 712-719
        • Challen J
        • Tang Y
        • Hazratwala K
        • Stuckey S
        Accuracy of MRI diagnosis of internal derangement of the knee in a non-specialized tertiary level referral teaching hospital.
        Australas Radiol. 2007; 51: 426-431
        • Nenezic D
        • Kocijancic I
        The value of the sagittal-oblique MRI technique for injuries of the anterior cruciate ligament in the knee.
        Radiol Oncol. 2013; 47: 19-25
        • Qin L
        • Li M
        • Yao W
        • Shen J
        Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries-a CT-based study.
        Sci Rep. 2017; 7: 41360
        • Albtoush O
        • Ghafel A
        • Al-Mnayyis A
        • Farah R
        • Othman A
        • Springer F
        Segond fracture associated with avulsion of both anterior and posterior cruciate ligaments.
        Rofo. 2020; 192: 576-578
        • Peltola E
        • Mustonen A
        • Lindahl J
        • Koskinen S
        Segond fracture combined with tibial plateau fracture.
        AJR Am J Roentgenol. 2011; 197: W1101-W1104