Abstract
Purpose
To describe rupture patterns of partial anterior cruciate ligament (ACL) tears on magnetic resonance (MR) imaging.
Methods
MR images of 51 patients with a surgically confirmed partial ACL tear were retrospectively and independently interpreted by 2 experienced, blinded radiologists. Using previously described MR criteria, ACLs were categorized as follows: complete tear, partial tear, isolated anteromedial or posterolateral bundle tear, mucoid degeneration or normal ACL. MR interpretations were compared with the arthroscopic results as the standard of reference. Inter- and intraobserver agreements were determined using kappa (к) coefficients.
Results
On MR imaging, ACL injuries were categorized as complete tears (16–23%), partial tears (20–47%), mucoid degeneration (12–27%) or normal ACLs (18–23%). Isolated ACL bundle tears were diagnosed on MR in 6% of our patients. Accuracy of MR for the diagnosis of partial ACL tears was 25–53%. Interobserver agreement was moderate (к = 0.48–0.56). Intraobserver agreement was good (к = 0.72–0.76).
Conclusion
MR diagnosis of a partial ACL tear is difficult because various tear patterns may be seen. Many partial tears demonstrate MR features that are indistinguishable from complete ACL tear, mucoid ACL degeneration or normal ACL. An isolated ACL bundle tear is infrequently detected on MR images.
Level of evidence
Testing of previously developed diagnostic criteria in non-consecutive patients, Level III.
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References
Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. AJR Am J Roentgenol 182:1283–1287
Colombet P, Dejour D, Panisset JC, Siebold R, French Arthroscopy Society (2010) Current concept of partial anterior cruciate ligament ruptures. Orthop Traumatol Surg Res 96(8 Suppl):S109–S118
DeFranco MJ, Bach BR Jr (2009) A comprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am 91:198–208
Duc SR, Zanetti M, Kramer J, Käch KP, Zollikofer CL, Wentz KU (2005) Magnetic resonance imaging of anterior cruciate ligament tears: evaluation of standard orthogonal and tailored paracoronal images. Acta Radiol 46:729–733
Jung JY, Yoon YC, Kwon JW, Ahn JH, Choe BK (2009) Diagnosis of internal derangement of the knee at 3T MR imaging: 3D isotropic intermediate-weighted versus 2D sequences. Radiology 253:780–787
Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Orthop Traumatol Surg Res 96:400–406
Makino A, Pascual-Garrido C, Rolón A, Isola M, Muscolo DL (2011) Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative and histological findings. Knee Surg Sports Traumatol Arthrosc 19:408–411
McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Skeletal Radiol 30:312–315
Moore SL (2002) Imaging the anterior cruciate ligament. Orthop Clin N Am 33:663–674
Nakamae A, Ochi M, Deie M, Adachi N, Kanaya A, Nishimori M, Nakasa T (2010) Biomechanical function of anterior cruciate ligament remnants: how long do they contribute to knee stability after injury in patients with complete tears? Arthroscopy 26:1577–1585
Notohamiprodjo M, Horng A, Pietschmann MF, Müller PE, Horger W, Park J, Crispin A, del Olmo JR, Weckbach S, Hermann KA, Reiser MF, Glaser C (2009) MRI of the knee at 3T: first clinical results with an isotropic PDfs-weighted 3D-TSE sequence. Invest Radiol 44:585–597
Petersen W, Zantop T (2006) Partial rupture of the anterior cruciate ligament. Arthroscopy 22:1143–1145
Resnick D (2007) The knee. In: Resnick D, Kang HS, Pretterklieber ML (eds) Internal derangements of joints, 2nd edn. Elsevier-Saunders, Philadelphia, pp 1813–1830
Roberts CC, Towers JD, Spangehl MJ, Carrino JA, Morrison WB (2007) Advanced MR imaging of the cruciate ligaments. Radiol Clin N Am 45:1003–1016
Starman JS, Vanbeek C, Armfield DR, Sahasrabudhe A, Baker CL III, Irrgang JJ, Fu FH (2007) Assessment of normal ACL double bundle anatomy in standard viewing planes by magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 15:493–499
Steckel H, Vadala G, Davis D, Fu FH (2006) 2D and 3D 3-tesla magnetic resonance imaging of the double bundle structure in anterior cruciate ligament anatomy. Knee Surg Sports Traumatol Arthrosc 14:1151–1158
Steckel H, Vadala G, Davis D, Musahl V, Fu FH (2007) 3-T MR imaging of partial ACL tears: a cadaver study. Knee Surg Sports Traumatol Arthrosc 15:1066–1071
Umans H, Wimpfheimer O, Haramati N, Applbaum YH, Adler M, Bosco J (1995) Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging. AJR Am J Roentgenol 165:893–897
Van Dyck P, Vanhoenacker FM, Gielen JL, Dossche L, Van Gestel J, Wouters K, Parizel PM (2011) Three-tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol 40:701–707
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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 Surg Sports Traumatol Arthrosc 20, 256–261 (2012). https://doi.org/10.1007/s00167-011-1617-7
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DOI: https://doi.org/10.1007/s00167-011-1617-7