VALIDITY OF ULTRASOUND AND MAGNETIC RESONANCE IMAGING FINDING IN PATIENT WITH ANTERIOR CRUCIATE LIGAMENT INJURY

Ahmed Younus Lafta, Hasanain Ahmed Jasim, Mohannad Ali Hasan

 

College of Medicine, University of Babylon. Babylon, Iraq.

T

he Anterior Cruciate Ligament (ACL) is one of 4 major ligaments of the knee. Magnetic resonance imaging (MRI) has a highly effective non-invasive diagnostic modality for ACL injuries. Ultrasound (US) technique has a promising and effective tool in the diagnosis of ACL injuries within the knee.

Purpose. To assess the validation of US and MRI in the detection of ACL tears and to determine the accuracy between ultrasound and MRI in the distinguishing of ACL Injury.

Materials and methods. A prospective validation study of 40 patients with knee joint trauma, at a period from 26th July 2023 to 29th May 2024. All these were sent for knee joints MRI with suspicion of ACL injuries. Data collected include age of patient, sex, side of knee (right or left), History of knee injury or surgery and comorbid conditions. US findings included tears, types of tear and associated lesions. MRI findings include ACL tear, direct signs and in-direct signs. US to knee joints was done using B-mode and MRI 1.5-Tesla was used.

Results. In this study, the mean age of patients was 43.35±13.2 yrs, 28 were males (70%) and 12 were females (30%). Right side knee joint effected was reported in 60% of cases while left side was reported in 40%. Ligamentous lesions were visualized in most of 28 patients (70%). The complete ACL tear was detected in four patients. The partial tear seen in 21 patients (52.5%). The commonest MRI sign was thickening of edema noticed in 14 cases (35%). Nine patients (22.5%) were detected with tear by US. MRI showed greater sensitivity and specificity (92% and 90%), respectively with accuracy rate reached to 90% with a high statistical significant (p<0.0001). The MRI was superior to US in the validity finding in patient with ACL injury and ligamentous lesions of knee joint (p<0.0001).

Discussion. In 2024, Voinea et al., Schwartz et al., Schulc et al., Gul et al. discussed the roles of MRL in the diagnosed of ligaments tear of knee. They confirmed the superiority of MRI aver US. In the present study, MRI showed greater sensitivity and specificity (92% and 90%), respectively with accuracy rate reached to 90% in diagnosis of ligamentous lesions of knee joint with a high statistical significant (p<0.0001). In regard to US parameters, there was no significant difference in detection of tear (79% sensitivity, 77% specificity) and tear types (78% sensitivity, 77% specificity). The MRI was superior to US in the validity finding in patient with ACL injury and ligamentous lesions of knee joint (Youden's index=0.82 vs. 0.56, AUC=0.967 vs. 0.65, p<0.0001). Zhao et al. found that the sensitivity, specificity, and accuracy of MRI in the diagnosis of ACL injury were 95.45%, 91.67%, and 94.87%, respectively, which was higher than we estimated. They showed high accuracy rates among direct MRI sign than indirect. In large meta-analysis study, Raheem et al. searched 199 published papers about MRI roles in diagnosis of knee ligamentous injuries. They found that sensitivity, specificity, of ultrasound were 80.16%, 89.56%, respectively, for ACL tears while for MRI were 96.08%, 84.86%, respectively.

Conclusion. The MRI is superior to US in the validity finding in patient with ACL injury and ligamentous lesions of knee joint. MRI have greater sensitivity and specificity (92% and 90%), respectively with accuracy rate reached to 90%.

 

Keywords: anterior cruciate ligament, MRI, ligamentous lesions, complete tear, ultrasonography.

 

Corresponding author: Ahmed Younus Lafta, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Ahmed Younus Lafta, Hasanain Ahmed Jasim, Mohannad Ali Hasan. Validity of ultrasound and magnetic resonance imaging finding in patient with anterior cruciate ligament injury. REJR 2024; 14(3):91-102. DOI: 10.21569/2222-7415-2024-14-3-91-102.

Received:        12.07.24 Accepted:       07.08.24