Yonsei Med J.  2012 Jul;53(4):820-824. 10.3349/ymj.2012.53.4.820.

Magnetic Resonance Arthrographic Dissection of Posterolateral Corner of the Knee: Revealing the Meniscofibular Ligament

• Lee YH
• Song HT
• Kim S
• Kim SJ
• Suh JS

• KMID: 1716884
• DOI: http://doi.org/10.3349/ymj.2012.53.4.820

Abstract

PURPOSE
To evaluate meniscofibular ligament (MFibL) at the posterolateral corner of the knee joint on the magnetic resonance arthrography (MRA) with 70degrees knee flexion.
MATERIALS AND METHODS
The MRA of the knee joint was performed at 70degrees knee flexion. Eighteen patients (19 knee joints) underwent scanning of sagittal, coronal, and axial fat-suppressed T1 weighted images (T1FS), and coronal fat-suppressed T2 weighted images. Sagittal three-dimensional (3D) gradient echo (GRE) images were also obtained. Retrospective review of 19 knee MRA studies was independently performed by two musculoskeletal radiologists. The statistical significance was proved by chi-square test.
RESULTS
The MFibL ligament was optimally demonstrated on the far lateral sagittal 3D GRE and T1FS MRA images. The MFibL appeared as a curvilinear or straight hypointense band of variable thickness, extended from the posterolateral meniscus to upper anteromedial aspect of the fibular head. The MFibL was demonstrated with scale 2 (more than a half length of the ligament) by both reviewers in 73.68% (n=14/19) of the knee 3D GRE images and 89.47% (n=17/19) of the knee T1FS images. The visualization on T1FS and that on GRE were not statistically different from each other (p>0.05). The interobserver agreements were significantly good on both 3D GRE and T1FS images in detecting the ligament (kappa values, 0.642 and 0.683, respectively).
CONCLUSION
The MFibL is well visualized on the far lateral sagittal MRA at 70degrees knee flexion, which could potentially be useful in recognizing structures in the posterolateral corner of the knee, including the MFibL.

Keyword

Magnetic resonance imaging; knee joint; meniscofibular ligament; MR arthrography

MeSH Terms

Adult
Female
Humans
Knee Joint/*pathology
Ligaments/*pathology
Magnetic Resonance Imaging/*methods
Male
Middle Aged
Young Adult

Figure

• 

  Fig. 1 MR arthrographic appearance of the meniscofibular ligament (MFibL). (A and B) A sagittal fat suppressed T1 weighted image of MR arthrography (A) and a corresponding sagittal 3D gradient echo MR arthrography (B) demonstrate the MFibL as a linear hypointense structure (white arrows) extending between the apex of the fibular head and the posterior third of the lateral meniscus. The popliteus tendon is located posterior to MFibL (black arrow). (C) Virtual MR arthroscopy reveals the relationship between the popliteus tendon and the MFibL (white arrows). LC, lateral condyle of femur; T, tibia; F, fibula; LM, lateral meniscus; MR, magnetic resonance; 3D, three-dimensional.

• 

  Fig. 2 MR arthrographic appearance of meniscofibular ligament (MFibL). Continuous sagittal fat suppressed T1 weighted images of knee MR arthrography demonstrate the MFibL as a linear, hypointense structure (white arrows), extending between the apex of the fibular head and the posterior third of the lateral meniscus. The popliteus tendon is located posterior to MFibL (black arrow). LC, lateral condyle of femur, T, tibia; F, fibula; FCL, fibular collateral ligament; BF, biceps femoris tendon; MR, magnetic resonance.

• 

  Fig. 3 Posterosuperior and posteroinferior popliteomeniscal fascicules. A sagittal fat suppressed T1 weighted image of MR arthrography (A) and a corresponding sagittal 3D gradient echo MR arthrography (B) demonstrate the posteosuperior (black arrow) and posteroinferior (white arrow) popliteomeniscal fascicles. LC, lateral condyle of femur; T, tibia; MR, magnetic resonance; 3D, three-dimensional.

• 

  Fig. 4 The difference between fat suppressed T1 weighted image and 3D gradient echo image. A sagittal fat suppressed T1 weighted image of MR arthrography (A) demonstrates the MFibL as a linear hypointense structure (white arrows). The popliteus tendon is located posterior to the MFibL (black arrow). However, the MFibL can partially be delineated on the corresponding sagittal 3D gradient echo MR arthrography (B). LC, lateral condyle of femur; T, tibia; F, fibula; MFibL, meniscofibular ligament; MR, magnetic resonance; 3D, three-dimensional.

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