Filisteev P.A.1,2,3, Semenov A.I.1, Zarov A.Y.1 Kondrashin S.A.3, Serova N.S.3, Ternovoy S.K.3,4
1 - St. Alexius Hospital. Moscow, Russia.
2 - Central Clinical Hospital. Moscow, Russia
3 - Sechenov University. Moscow, Russia.
4 - National Cardiology Research Center. Moscow, Russia.
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urpose. To evaluate the diagnostic performance of functional magnetic resonance imaging (fMRI) in detecting anterior cruciate ligament (ACL) graft injuries of the knee.
Materials and methods. Prospectively, 38 consecutive patients with suspected ACL graft injury of the knee underwent standard magnetic resonance imaging (MRI), fMRI, and follow-up arthroscopy.
MRI included standard orthogonal axial, sagittal, coronal images, as well as oblique sagittal and coronal T2-weighted images along the ACL graft. fMRI was carried out according to a method previously developed by us.
The degree of ACL graft damage on all MR images was determined using a 3-point classification, where 0 is a normal graft, 1 is a partial tear, and 2 is a complete tear. The results obtained were compared with the results of arthroscopy.
Results. fMRI in the diagnosis of ACL graft injuries compared with MRI showed an increase in sensitivity by 29,4% for normal ACL graft, by 33,3% for partial tears, by 26,6% for complete tears, an increase in specificity by 14,2% for normal graft, 15,7% for partial tears, 13,0% for full-thickness tears, and an increase in accuracy by 21,0%, 18,4% и 18,4% respectively.
Mean confidence levels for correct diagnosis were significantly higher for fMRI than for MRI (p<0.01).
Diagnostic agreement between MRI and arthroscopy was k=0.430. Performing fMRI significantly increased diagnostic agreement with arthroscopy with values of k=0.874.
Discussion. fMRI using the developed method improves the accuracy of diagnosing ACL graft injuries and makes it possible to differentiate knee laxity and motion restriction reasons. The new fMRI signs of ACL graft rupture that we have identified can be used to conduct similar functional studies of the knee joint.
Conclusion. fMRI showed higher sensitivity, specificity and accuracy than MRI for each grade of ACL graft injury measured. fMRI compared with MRI significantly increases diagnostic agreement with arthroscopy and increases the reliability of the correct diagnosis when assessing the ACL graft.
Keywords: fMRI, knee instability, ACL, ACL graft, ACL graft rupture, partial ACL graft rupture, complete ACL graft rupture, knee joint, anterior cruciate ligament.
Corresponding author: Filisteev P.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Filisteev P.A., Semenov A.I., Zarov A.Y., Kondrashin S.A., Serova N.S., Ternovoy S.K. Functional magnetic resonance imaging in the diagnosis of anterior сruciate ligament graft injuries of the knee joint. REJR 2025; 15(3):221-231. DOI: 10.21569/2222-7415-2025-15-3-221-231.
Received: 13.09.25 Accepted: 30.10.25