Korean J Radiol.  2004 Mar;5(1):47-54. 10.3348/kjr.2004.5.1.47.

CT Arthrography and Virtual Arthroscopy in the Diagnosis of the Anterior Cruciate Ligament and Meniscal Abnormalities of the Knee Joint

• Lee W
• Kim HS
• Kim SJ
• Kim HH
• Chung JW
• Kang HS
• Hong SH
• Choi JY

• KMID: 1066245
• DOI: http://doi.org/10.3348/kjr.2004.5.1.47

Abstract

OBJECTIVE
To determine the diagnostic accuracy of CT arthrography and virtual arthroscopy in the diagnosis of anterior cruciate ligament and meniscus pathology. MATERIALS AND METHODS: Thirty-eight consecutive patients who underwent CT arthrography and arthroscopy of the knee were included in this study. The ages of the patients ranged from 19 to 52 years and all of the patients were male. Sagittal, coronal, transverse and oblique coronal multiplanar reconstruction images were reformatted from CT arthrography. Virtual arthroscopy was performed from 6 standard views using a volume rendering technique. Three radiologists analyzed the MPR images and two orthopedic surgeons analyzed the virtual arthroscopic images. RESULTS: The sensitivity and specificity of CT arthrography for the diagnosis of anterior cruciate ligament abnormalities were 87.5%-100% and 93.3-96.7%, respectively, and those for meniscus abnormalities were 91.7%-100% and 98.1%, respectively. The sensitivity and specificity of virtual arthroscopy for the diagnosis of anterior cruciate ligament abnormalities were 87.5% and 83.3-90%, respectively, and those for meniscus abnormalities were 83.3%-87.5% and 96.1-98.1%, respectively. CONCLUSION: CT arthrography and virtual arthroscopy showed good diagnostic accuracy for anterior cruciate ligament and meniscal abnormalities.

Keyword

Knee, CT; Knee, arthrography; Knee, ligaments, menisci, and cartilage

MeSH Terms

Adult
Anterior Cruciate Ligament/injuries/*radiography
Arthrography/*methods
Arthroscopy/*methods
Diagnosis, Computer-Assisted/methods
Human
Knee Injuries/*diagnosis/radiography
Male
Menisci, Tibial/injuries/*radiography
Middle Aged
Sensitivity and Specificity
Tomography, X-Ray Computed/methods

Figure

• 

  Fig. 1 Medial meniscus tear in a 28-year-old man with knee pain after trauma. A. Sagittal CT image clearly demonstrating an oblique tear of the medial meniscus (arrow). B. Virtual arthroscopy of the medial meniscus showing cleavage (arrow) and a rugged free margin of torn meniscus (arrowheads). The tibial plateau (asterisk) and femur condyle (curved arrow) are also shown.

• 

  Fig. 2 CT arthrography and virtual arthroscopy of the lateral meniscus tear of a 29-year-old man with knee joint pain. A. Coronal CT arthrography showing a vertical and horizontal tear of the lateral meniscus (arrow). Note the intact medial collateral ligament (arrowheads). B. Virtual arthroscopy showing cleavage of the meniscus (arrow) and a displaced meniscus central segment (arrowhead). The tibia plateau (asterisk) and femur condyle (curved arrow) are clearly demonstrated.

• 

  Fig. 3 CT arthrography of the normal anterior cruciate ligament of a 27-year-old male. A. Oblique coronal CT arthrography showing a well demarcated linear anterior cruciate ligament (arrowheads). The small amount of contrast media on the tibial side was considered a normal finding (arrow). B. Virtual arthroscopic view of the normal anterior cruciate ligament (arrow). The smooth margin and continuity to the intercondylar notch are clearly demonstrated (arrowheads).

• 

  Fig. 4 A tear in the anterior cruciate ligament of a 20-year-old man with knee joint pain after trauma A. Arthroscopy showing a rugged torn fiber of the anterior cruciate ligament. One arthroscopist judged that there was a 50% partial tear of the anterior cruciate ligament. The ridge of the intercondylar notch (arrowheads) and the torn anterior cruciate ligament (arrow) are shown. B. Virtual arthroscopy showing an anterior cruciate ligament with abnormal shape and orientation. The ridge of the intercondylar notch is shown (arrowheads). The anterior cruciate ligament has lost its normal continuity and has an irregular torn margin (arrow).

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