Application of FMRI in Diagnosis of Anterior Cruciate Ligament Injury

Application Value of Flexion Position MRI in Diagnosis of Anterior Cruciate Ligament Injury and Patellofemoral Instability

1. To compare the knee joint MRI 30 ° The flexion position was similar to that of conventional knee joint coil (about 17 °） The advantages and disadvantages in the description and diagnosis of anterior cruciate ligament injury;,2. To compare the knee joint MRI 30 ° The flexion position was similar to that of conventional knee joint coil (about 17 °） Advantages and disadvantages in description and diagnosis of patellofemoral instability

Study Overview

• Status: Completed
• Conditions: Anterior Cruciate Ligament Injuries
• Intervention / Treatment: Diagnostic test: Knee joint 30° flexion scan

Detailed Description

Magnetic resonance imaging is widely used in the imaging diagnosis of knee joint injury. At present, there are two kinds of scanning coils used in our country. One is flexible surface coil, and the patient is 0 ° Scan in the straight position. The other is the special coil for the knee joint. At this time, because the coil itself is hard material and has a certain height, the patient is actually in the knee joint micro bending position (about 17 ° 1) Scan. However, it may not be accurate enough to evaluate ACL injury and patellofemoral instability with knee scan in extension and micro flexion position.,1、 Previous literatures have shown that flexion position is superior to extension position in the description and diagnosis of anterior cruciate ligament injury. The main reasons include: ① in extension position, the femoral attachment is wider and flat, with the increase of flexion angle, the anterior cruciate ligament fiber bundle is twisted, and the femoral segment is narrower in sagittal position, Thus, it can be clearly shown as a cylindrical bundle structure 2; ② The normal ACL was tensioned in the extension position, so the femoral attachment area was not well displayed. With the increase of flexion angle, the femoral segment separated from the intercondylar crest area, and the volume of intercondylar fossa increased; ③ Due to the influence of partial volume artifacts in the extension position, the normal anterior cruciate ligament may also show uneven MRI signal, which is similar to injury, resulting in false positive, while the flexion position can reduce partial volume artifacts. However, there are few studies on the advantages and disadvantages of flexion and micro flexion scanning in the description and diagnosis of anterior cruciate ligament injury at home and abroad.,2、 The medical research of patellofemoral instability found that in the early stage of knee flexion, the patella of normal people began to move to the medial side of the knee while sliding from the starting position to the distal side ° The patella moved inward gradually to the maximum, then turned to the lateral and moved to the knee flexion of 40 ° The patella returned to the median line 4. The patients with patellofemoral instability were 15 °- forty-five ° The center of patella moved from the initial position to the lateral position continuously for 5, so 30 ° The difference between normal people and patients may be more significant.,The purpose of this study is to explore 30 cases ° Application value of flexion position in diagnosis of anterior cruciate ligament injury and patellofemoral instability.

2.Image analysis：Comparison of the diagnosis of anterior cruciate ligament injury between conventional scan position and 30°flexion scan

(1) Two radiologists respectively evaluated the injury of the anterior cruciate ligament.

The evaluation criteria for the full length display status are as follows: 3 points: The anterior cruciate ligament is continuously displayed on multiple levels or the full length is displayed in one level, without obvious artifacts; 2 points: The full length of the anterior cruciate ligament cannot be displayed completely but the section can be displayed, there are artifacts but it does not affect the observation; (1)point: The full length of the anterior cruciate ligament cannot be identified or artifacts affect the observation. The evaluation criteria for the display status of the tearing point and stump are as follows: (3) points: The tear point and stump of the ACL are clearly displayed (2) points: One of the torn points or stumps of the ACL can be clearly displayed, and the other cannot be clearly displayed (1) point: The tear point and stump of the ACL cannot be clearly displayed

• Study Type: Observational
• Enrollment (Actual): 120

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 010
      • Peking University Third Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Outpatients or inpatients who were clinically diagnosed with patellofemoral instability and planned to undergo knee MRI examination from March 2018 to October 2018

Description

Inclusion Criteria: Hospitalized patients who have a clear history of knee joint sports injury who are planning to undergo knee arthroscopy -

Exclusion Criteria: MR examination found to have the following diseases: rheumatoid arthritis, septic arthritis, tumor, joint fibrosis; History of knee surgery.

-

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
30 ° flexion position; Scan the knee at 30° flexion	Diagnostic test: Knee joint 30° flexion scan; The patient was placed in the supine position, and the knee joint was naturally placed in the knee joint special coil, and the knee joint 30° flexion position scan.
conventional flexion position; Routine body scan of the knee joint

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Damage diagnosis	Arthroscopy was used as the gold standard to evaluate the ACCURACY of the two methods in the diagnosis of ligament injury	2019.1.15-2019.1.30

Collaborators and Investigators

• Sponsor: Peking University Third Hospital
• Investigators: Study Chair: Huishu Yuan, Peking University Third Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2018
• Primary Completion (Actual): October 13, 2018
• Study Completion (Actual): January 31, 2019

Study Registration Dates

• First Submitted: June 28, 2021
• First Submitted That Met QC Criteria: July 1, 2021
• First Posted (Actual): July 12, 2021

Study Record Updates

• Last Update Posted (Actual): July 12, 2021
• Last Update Submitted That Met QC Criteria: July 1, 2021
• Last Verified: March 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Leg Injuries; Knee Injuries; Wounds and Injuries; Anterior Cruciate Ligament Injuries
• Other Study ID Numbers: M2018014

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No