年轻军人膝关节前交叉韧带损伤的MRI CT影像学表现及影像学相关影响因素研究

doi:10.3969/j.issn.1006-6233.2025.03.028

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Abstract Objective: To investigate the MRI and CT imaging findings of anterior cruciate ligament (ACL) injury in young soldiers and to analyze imaging-related influencing factors. Methods: A retrospective analysis was conducted on 101 young soldiers with unilateral knee discomfort due to non-contact mechanisms treated at our hospital from May 2021 to April 2023. All patients underwent MRI, CT, and arthroscopy. Based on arthroscopy results, patients were divided into an ACL rupture group (n=68) and a normal ACL group (n=33). The diagnostic efficacy of MRI and CT for ACL injury was evaluated, and imaging findings were analyzed. Univariate and multivariate logistic regression analyses were performed to identify imaging-related influencing factors for ACL rupture. Results: Arthroscopy revealed 33 cases with normal ACL and 68 cases with ACL rupture (30 complete ruptures and 38 partial ruptures). CT imaging showed that partial ACL ruptures exhibited ligament thickening and blurred boundaries, while complete ruptures displayed ligament distortion and thickening. On MRI, partial ruptures showed localized signal enhancement in the coronal plane, while complete ruptures exhibited discontinuous and lumpy shadows with diffuse signal enhancement. In the sagittal plane, partial ruptures demonstrated overall thinning with localized thickening and maintained continuity, whereas complete ruptures appeared wavy with stump spasm and signal enhancement. Using arthroscopy as the gold standard, MRI and CT had sensitivities of 94.12% and 85.29%, specificities of 78.79% and 75.76%, and accuracies of 89.11% and 82.18%, respectively. Significant differences were observed in intercondylar fossa morphology, intercondylar fossa width, tibial intercondylar eminence width, and the ratio of tibial intercondylar eminence width to intercondylar fossa width between the ACL rupture and normal groups (P<0.05). Multivariate logistic regression identified type A intercondylar fossa morphology and a low ratio of tibial intercondylar eminence width to intercondylar fossa width as significant imaging-related influencing factors for ACL rupture (P<0.05). Conclusion: MRI and CT imaging findings for ACL injury in young soldiers differ, with MRI demonstrating slightly higher diagnostic efficacy. Type A intercondylar fossa morphology and a low ratio of tibial intercondylar eminence width to intercondylar fossa width are significant imaging-related influencing factors for ACL rupture in this population.

Key words： Knee joint Anterior cruciate ligament rupture Soldiers Imaging Influencing factors

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.03.028 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I3/504

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