Value of magnetic resonance imaging in the diagnosis of anterior cruciate ligament tear with ramp lesion
Dong Wanting
Wang Haodong
Pan Xiaowen
Luo Fei
Yi Xuebing
Abstract：Objective To explore the value of preoperative magnetic resonance imaging(MRI)in diagnosing Ramp lesions in patients with anterior cruciate ligament(ACL)tears,in order to provide clinical support.Methods A total of 126 patients with ACL tears treated at the Sichuan Provincial Orthopedic Hospital from June 2019 to July 2022 were selected as the study participants and underwent MRI and arthroscopic examination.The value of MRI in diagnosing Ramp lesions was compared and analyzed,and the clinical and imaging data differences between patients with and without Ramp lesions were analyzed to determine the influencing factors of ACL tear with Ramp lesion.Results The Kappa value of consistency between MRI di-agnosis and arthroscopic examination was 0.527(P＜0.001),indicating moderate consistency.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI in diagnosing ACL with Ramp lesion were 45.00％,98.11％,89.68％,82.82％,and 90.43％,respectively.The proportion of patients with a disease course of ≥6 weeks in the combined Ramp lesion group was higher than that in the non-combined Ramp lesion group(P＜0.05).No statistically significant difference was observed in gender composition,age,body mass index,and other factors between the two groups(P＞0.05).In the combined Ramp lesion group,significantly higher proportions of high-signal linear fluid were found at the posterior horn of the medial meniscus connected to the joint capsule,longitudinal tears at the posterior horn of the medial meniscus,anterior displacement of the tibia,medial condyle bruising of the femur,and complete ACL tear com-pared to the non-combined Ramp lesion group(P＜0.05).The results of multivariate stepwise logistic regression analysis showed that the disease course,high-signal linear fluid at the posterior horn of the medial meniscus connected to the joint capsule,longitudinal tears at the posterior horn of the medial meniscus,anterior displacement of the tibia,and medial con-dyle bruising of the femur were influencing factors for Ramp lesions in patients with ACL tears(P＜0.05).Conclusion MRI has low sensitivity but high specificity in diagnosing ACL tears combined with Ramp lesions.The occurrence of ACL tears with Ramp lesions is influenced by the disease course,high-signal linear fluid at the posterior horn of the medial menis-cus connected to the joint capsule,longitudinal tears at the posterior horn of the medial meniscus,anterior displacement of the tibia,and medial condyle bruising of the femur.This study has replicated the clinical situation and has practical value.
Keywords：Anterior cruciate ligament tearMagnetic resonance imagingRamp lesionDiagnostic value
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 65-69 )