EVALUATION OF THE ANTEROLATERAL LIGAMENT OF THE KNEE IN MAGNETIC RESONANCE MRI: CASE SERIES

ABSTRACT Objective: To evaluate the citation of the ligament in the magnetic resonance imaging (MRI) reports and confirm its presence and injury in the images of exams performed in the acute phase retrospectively. Methods: In total, 103 patients who underwent anterior cruciate ligament (ACL) reconstruction in 2019 were included. The images were reanalyzed by two radiologists. Results: In the first analysis, only one report mentioned the anterolateral ligament (ALL) and its injury (0.97%). On reanalysis, ALL was visualized in almost all cases (95% and 97%). An injury was found in 53 (51.5%) cases by radiologist A and in 56 (54.4%) cases by radiologist B. The injury was diagnosed by both in 39 (37.9%) cases (p &lt; 0.0001). Radiologists disagreed regarding the injury (Kappa = 0.411). Conclusion: The reports failed to describe the ligament and diagnose a significant number of injuries. The analysis of conventional resonance images still presents divergences in the diagnosis of ALL injury associated with the ACL among radiologists. Level of Evidence IV, Case Series.摘要 研究目的：评估磁共振成像（magnetic resonance imaging, MRI）报告中对韧带的提及情况，并回顾性确认急性期检查图像中该韧带的存在及其损伤状态。方法：纳入2019年接受前交叉韧带（anterior cruciate ligament, ACL）重建术的103例患者，由两名放射科医师对其影像学图像进行重新分析。结果：首次阅片时，仅1份原始报告提及前外侧韧带（anterolateral ligament, ALL）及其损伤（占比0.97%）；经重新分析，两名医师均在绝大多数病例中观察到前外侧韧带（检出率分别为95%和97%）。医师A检出53例（51.5%）存在韧带损伤，医师B检出56例（54.4%），两名医师共同确诊存在损伤的病例共39例（37.9%，p < 0.0001）。二者对该损伤的诊断一致性一般（Kappa值=0.411）。结论：现有磁共振成像报告未对该韧带进行描述，且漏诊了大量损伤病例；针对合并前交叉韧带损伤的前外侧韧带损伤的常规磁共振图像诊断，不同放射科医师间仍存在分歧。证据等级：IV级，病例系列研究。