Observations Of The Cruciate Ligament In The Knee On The MRI And Diffusion Tenser Imaging

Background Cruciate ligament tear was a common knee joint disease,and it had great influence on the stability of the knee joint.The precise prognosis was important for clinicians to choose the proper treatment plan.MRI could clearly show the injuries of cruciate ligament and the injury scope.The rate of accuracy diagnosis of complete anterior cruciate ligament tear reached 91%⁹9%,but the rate of partial anterior cruciate ligament tear accuracy was only 56%⁸7%,which still had some limitations.Objective By using MRI multiplanar reconstruction,volume rendering and diffusion tensor imaging technology,we observed the cruciate ligament anatomical structure and signal characteristics,and tibial angle,position,size,diameter,in the femoral and tibial attachment point of morphology,and the fractional anisotropy（FA）values and apparent diffusion coefficient（ADC）value and its change regulation,and the correlations between fractional anisotropy（FA）value of anterior cruciate ligament and measurement results of MRI,and accuracy of diagnosis of the cruciate ligament injury,to provide reference basis for treatment and postoperative evaluation of cruciate ligament laceration and.Methods During January 2015 to June 2016,we enrolled 100 cases of healthy adults who had MRI and diffusion tensor imaging examination of lower limbs,including 50 males and 50 females,aged 26-53 years.we enrolled 70 cases of patients wito cruciate ligament injury were（70 sides of the knee joint）,aged 21-50 years,including 39 males（20 sides of the left knee and 19 side of the right knee）and 31 females（11 sides of the left knee and 20 side of the right knee）.The MRI images were transmitted to the 3D reconstruction workstation by multiplanar reconstruction and volume rendering technique to reconstruct and measure knee joint MRI.By fusion of diffusion tensor imaging（DTI）of the original image and anatomical images,we divided the anterior cruciate ligament average into 5 regions,and got the regional fractional anisotropy（FA）pseudo color pictures and graph fusion,measured the pseudo color pictures of fractional anisotropy（FA）value and the apparent diffusion coefficient（ADC）value from the interest regions.We used SPSS 17.0 software for statistical procession.Results1 Anterior cruciate ligament of the sagittal position of anterior cruciate ligamenttibial angles,coronary anterior cruciate ligament-tibial angles,blumensaat line-anterior cruciate ligament angles,intercondylar fossa roof angles,anterior cruciate ligament tibial insertion points,between the left and the right sides and btween the males and females had no significant difference（P>0.05 53.23±2.30 °,52.45± 2.83°,12.73± 0.66 °,39.67± 3.10 °,24.67±1.48 % respectively）.The transverse diameter,longitudinal diameter in femoral and tibial attachment area were（47.15±3.44）mm²,（4.90±1.94）mm,（9.93±2.13）mm and（92.77±2.73）mm²,（16.84±1.02）mm,and（14.43 ±1.31）mm respectively.At the site that anterior cruciate ligament attached tibial insertion,the area,horizontal diameter,longitudinal diameter were significantly greater than that at the site that anterior cruciate ligament attached femoral insertion（P<0.05）.The area,horizontal diameter,vertical diameter of anterior cruciate ligament（attaching tibial insertion）was significantly larger than that of the posterior cruciate ligament（P<0.05）.2 The area,transverse diameter,longitudinal diameter of posterior cruciate ligament femoral attached to tibial attachment were（93.25±4.33）mm²,（10.11±2.01）mm,（15.18±2.34）mm and（66.20±2.17）mm²,（9.61±1.97）mm,（9.57±2.28）mm respectively.The area,longitudinal diameter of posterior cruciate ligament femoral attached to femoral were significantly higher than that of the tibial attachment sites（P<0.05）.The area,longitudinal diameter of posterior cruciate ligament femoral attached to femoral were significantly higher than that of anterior cruciate ligament attached to femoral（P<0.05）.3 The diffusion tensor imaging of anterior cruciate ligament of in the fractional anisotropy（FA）values and apparent diffusion coefficient（ADC）values between the left and right,the male and female had no significant difference（P>0.05）.The fractional anisotropy（FA）of 1-5 region was（0.596±0.042）,（0.591±0.051）,（0.583± 0.045）,（0.563±0.059）,（0.481± 0.072）respectively.There were no significant differences between the 2 zone,and 3 zone to 1 zone（P>0.05）.There were significant differences between the 4zone,and 5 zone to 1 zone（P<0.05）.Apparent diffusion coefficient（ADC）of the 1-5 region were（0.994±0.216）10^-3mm²/s,（1.285±0.268）10^-3mm²/s,（1.290±0.197）10^-3mm²/s,（1.697±0.423）10^-3mm²/s,（1.804±0.384）10^-3mm²/s respectively.There were no significant differences between the 2 zone,and 3 zone to 1 zone（P>0.05）.There were significant differences between the 4 zone,and 5 zone to 1 zone（P<0.05）.4 Sagittal anterior cruciate ligament-tibial angle was negatively correlated with the 2zone,3 zone fractional anisotropy（FA）value.Blumensaat line-anterior cruciate ligament angle was negatively correlated with the 1 zone,4 zone fractional anisotropy（FA）value.The intercondylar fossa top angle was negatively correlated with the 4 zone,5 zone fractional anisotropy（FA）value.Anterior cruciate ligament tibial check point and the 4zone fractional anisotropy（FA）value was negatively correlated.Coronary anterior cruciate ligament-tibial angle and the area of the fractional anisotropy（FA）value had no correlation.5 The accuracy rate of MRI diagnosis for anterior cruciate ligament partial tear was92.86%,and the accuracy rate of completely tear was 98.57%.The accuracy rate in the diagnosis of anterior cruciate ligament partial tear and completely tear by diffusion tensor imaging were both 100%.Conclusion Diffusion tensor imaging could better display the partial cruciate ligament laceration than MRI plane restructuring and volumetric image,consistent with the "gold standard" arthroscopy.It could provide more information for clinical diagnosis.