基于术前MRI预测ACL重建中腘绳肌腱和腓骨长肌腱自体移植物直径
简介
本研究纳入52例初次前交叉韧带（ACL）重建患者，前瞻性评估术前MRI测量的腘绳肌腱（HT）和腓骨长肌腱（PLT）横截面积（CSA）对术中自体移植物直径的预测价值。结果显示：HT组中，股骨内侧髁水平的CSA与移植物直径相关性最强（r=0.782），最佳截断值为≥19.15 mm²（AUC 0.917，敏感性85%，特异性100%）；PLT组中，踝关节水平的C…
英文摘要
BACKGROUND: To evaluate the predictive value of magnetic resonance imaging (MRI)-derived cross-sectional area (CSA) measurements of hamstring and peroneus longus tendons in estimating intraoperative autograft diameter during anterior cruciate ligament (ACL) reconstruction, and to identify clinically useful CSA cut-offs for achieving graft diameters ≥ 8 mm. METHODS: Fifty-two patients undergoing primary ACL reconstruction were included in this prospective observational study, with 26 each in the hamstring tendon (HT) and peroneus longus tendon (PLT) autograft groups. Preoperative CSA was measured on axial MRI at specific anatomical levels. Intraoperative graft diameters were recorded post- harvest. Correlation analysis and receiver operating characteristic curves were used to assess predictive value and determine CSA thresholds for adequate graft size. RESULTS: For the HT group, CSA measured at the medial femoral condyle showed the strongest correlation with intraoperative diameter (r = 0.782; p < 0.001), with an optimal CSA cut-off of ≥ 19.15 mm² (AUC 0.917, sensitivity: 85%, specificity: 100%). For the PLT group, ankle-level CSA best predicted graft diameter (cut-off: ≥12.84 mm², AUC 0.958, sensitivity: 95.8%, specificity: 100%). CONCLUSION: MRI-based CSA measurement provides a reliable, non-invasive method for predicting autograft adequacy. This study establishes clinically relevant CSA thresholds for HT and PLT tendons and is the first to report such values for PLT, aiding preoperative graft selection in ACL reconstruction.