目 的 探讨并对比多层螺旋 CT(MSCT)和核磁共振(MR)在诊断膝关节交 叉韧带损伤中的应用价值。方法 选取我 院膝关节外科收治的膝关节闭合性损伤 患者56例作为研究对象，均行16层螺旋 CT(MSCT)和核磁共振(MR)扫描，并与关节 镜检查结果比较，对比影像学表现。结果 MSCT的MPR图像斜矢状位上患肢PCL角度、 PCL的CT值、AT角、ACL的CT值均显著低 于健肢(P＜0.05)；以关节镜诊断结果为 “金标准”，MSCT诊断符合率为95.24%； MR诊断符合率为98.41%，两者差异无统计 学意义(P＞0.05)。MSCT影像学表现交叉 韧带明显增厚、肿胀，密度降低，周围脂 肪间隙模糊，边缘清晰或无清晰边缘；撕 脱骨折表现为高密度游离骨折片与韧带相 连，部分出现韧带挛缩。MR影像学表现为 韧带明显增厚，T1、T2表现为不规则高或 稍高信号影，撕脱骨折表现为T1低信号， 韧带松弛呈波浪状；T2表现为不规则高信 号，部分存在明显骨组织分离征象。结论 MSCT扫描膝关节交叉韧带损伤结果与MR基 本相符，可作为临床诊断该类损伤的首选 影像学方式。

Objective To investigate and compare the application value of multi-slice spiral CT (MSCT) and magnetic resonance (MR) in the diagnosis of knee joint cruciate ligament injuries. Methods 56 patients with closed knee joint injury who were treated in the department of orthopaedics in our hospital were selected as the research objects. 16 slice spiral CT (MSCT) and magnetic resonance (MR) scanning were performed and the results were compared with those of arthroscopy. Results The PCL angle, CT value of PCL, AT angle and CT value of ACL of the injured limbs on oblique sagittal images of MSCT and MPR were significantly lower than those of the uninjured extremity (P＜0.05); The diagnostic results of arthroscopy were taken as the golden standard, the diagnostic accuracy of MSCT was 95.24% while of MR was 98.41% (P＞0.05). The imaging findings of MSCT showed obvious thickening and swelling of cruciate ligament, density decreasing, blurred peripheral fat spaces, clear edges or without clear edges; Avulsion fractures showed high-density free fracture flats attached to the ligament and part presence of contracture of the ligament. The imaging findings of MR showed obvious thickening of ligament. T1 and T2 showed irregular high or slightly high signal and avulsion fracture showed low signal on T1. Ligament relaxation is wavy; T2 showed irregular high signal and some obvious bone tissue separation signs. Conclusion The results of MSCT scan for knee joint cruciate ligament injuries are basically consistent with those of MR, which can be taken an preferred imaging method for the diagnosis of such diseases.