Magnetic resonance imaging of anterior cruciate ligament (ACL) tears: Diagnostic value of ACL-tibial plateau angle

Murao, Hiroshi; Morishita, Shinobu; Nakajima, Mikio; Abe, Muneaki

doi:10.1007/s007760050016

Cited by 25 publications

(21 citation statements)

References 19 publications

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“…ACL and Blumensaat angles are objective tests for evaluating the horizontal displacement of the distal ligament. It has been reported the mean ACL and Blumensaat angles in patients with a torn ACL were 23.9°-33.9° and 21.4°-25.8°, respectively (Table 3) [3,7,10,11]. In our study, the mean ACL and Blumensaat angles in the tear group were, respectively, 32° ± 7.1° and 19.8° ± 9.4°.…”

Section: Discussionsupporting

confidence: 51%

A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Findings and an Emphasis on Evaluating of ACL, Blumensaat, and PCL Angles

Çelikyay

Yüksekkaya

Bilgic

2020

Journal of the Belgian Society of Radiology

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To determine MRI findings that can differentiate anterior cruciate ligament (ACL) tears from mucoid degeneration. Material and Methods: Thirty-seven patients with complete ACL tears and 43 with ACL mucoid degeneration were included in this study. Discontinuity, the abnormal signal intensity of the ACL on fat-saturated-PD weighted images, contusions, a deep lateral femoral notch, anterior tibial translation, uncovered posterior horn of the lateral meniscus, a celery stalk appearance, thickening, ganglion cysts, intraosseous cysts, the ACL, Blumensaat, and posterior cruciate ligament (PCL) angles were evaluated. Optimum threshold values, sensitivity, specificity, and 95% CIs for the angles were calculated to predict the tear. Results: The prevalence of the significant findings in a tear versus mucoid degeneration, respectively, was as follows: discontinuity (97% vs. 0%, p < 0.001), contusions (65% vs. 2%, p < 0.001), the deep lateral femoral notch (22% vs. 0%, p = 0.001), anterior tibial translation (70% vs. 14%, p < 0.001), uncovered the lateral meniscus (46% vs. 7%, p < 0.001), a celery stalk appearance (0% vs. 66%, p < 0.001), thickening (19% vs. 100%, p < 0.001), ganglion cysts (14% vs. 70%, p < 0.001), and intraosseous cysts (8% vs. 63%, p < 0.001). Threshold values of ACL, Blumensaat, and PCL angles to predict the tear were ≤36° (78% sensitivity, 91% specificity), >11° (84%, 81%), and ≤96° (65%, 91%), respectively. Conclusion: A celery stalk appearance in the mucoid degeneration and discontinuity in an ACL tear are important in the differential diagnosis. ACL, Blumensaat, and PCL angles can be helpful in settings of diagnostic uncertainty.

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Section: Discussionsupporting

confidence: 51%

A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Findings and an Emphasis on Evaluating of ACL, Blumensaat, and PCL Angles

Çelikyay

Yüksekkaya

Bilgic

2020

Journal of the Belgian Society of Radiology

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“…Comparing the data from this study to the literature reveals similar results. The normal ACL angle in the sagittal plane ranges from 52°to 56° [10,21,24]. In this study, an average ACL-AM angle of 47.9°and ACL-PL angle of 42.9°was reported.…”

Section: Discussionmentioning

confidence: 83%

3-T MR imaging of partial ACL tears: a cadaver study

Steckel

Vadalà

Davis

et al. 2007

Knee Surg Sports Traumatol Arthr

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Magnetic resonance imaging (MRI) is the most commonly used diagnostic imaging procedure for suspected injuries to the anterior cruciate ligament (ACL). However, MRI has less utility for the evaluation of partial ACL tears. The goal of this study was to evaluate the possibility of distinguishing partial ACL tears applying the double bundle concept by dividing the ACL anatomy in the anteromedial (AM) and posterolateral bundle (PL). Six human cadaver knees were used in this laboratory study. The protocol consisted of sagittal, oblique coronal, and oblique sagittal proton-density-weighted fast spin echo sequences. After MRI the AM and the PL bundle were severed to mimic different partial ACL rupture patterns. MRI scanning of each knee was repeated, to record the quantitative parameters tilt and ACL angles and discontinuity as a nonquantitative parameter. Three orthopaedic surgeons and two radiologists were enlisted as blinded observers to evaluate the images. The transection patterns could be differentiated by evaluating discontinuity both in the paracoronal and in the sagittal plane. Evaluating the transection patterns, the AM bundle reached a better result in both planes compared to the PL bundle and the paracoronal plane had a better result in assessing the transection patterns compared to the sagittal plane for the PL bundle. Partial ACL transections could predictably be recognized on oblique sagittal and oblique coronal planes utilizing 3-T MRI technology. This concept allows a more precise description of ACL rupture patterns and might lead to a more distinctive approach for reconstructive surgery. The presurgical planning could be improved by applying a treatment algorithm based on a description of each bundle as intact or ruptured, leading to a reconstruction of the torn and a preservation of the intact bundle.

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“…Several studies have reported that the intact ACL angle on sagittal MRI using different measurement techniques has a mean sagittal ACL angle range of 50.4°to 58.7° [3,6,21,[31][32][33]45]. Data of other studies about reconstructed ACL or normal ACL are detailed in Table 4.…”

Section: Discussionmentioning

confidence: 98%

Normal sagittal of the anterior cruciate ligament can be reproduced using accessory anteromedial portal technique: a magnetic resonance imaging study

Cho

Kim

2012

Arch Orthop Trauma Surg

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Magnetic resonance imaging of anterior cruciate ligament (ACL) tears: Diagnostic value of ACL-tibial plateau angle

Cited by 25 publications

References 19 publications

A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Findings and an Emphasis on Evaluating of ACL, Blumensaat, and PCL Angles

A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Findings and an Emphasis on Evaluating of ACL, Blumensaat, and PCL Angles

3-T MR imaging of partial ACL tears: a cadaver study

Normal sagittal of the anterior cruciate ligament can be reproduced using accessory anteromedial portal technique: a magnetic resonance imaging study

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