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✅ Knee MRI Mastery/Chap 2.ACL and PCL

(Fig 2-E.24) Chronic Complete Tear of the PCL - Part 2

by MSK MRI 2024. 4. 28.

https://youtu.be/aXLAu1vhjek

https://youtu.be/UgiSgNcqguA

📌 Diagnosing Chronic PCL Tears

1️⃣ : Understanding PCL Appearance on MRI

  • Chronic tears of the Posterior Cruciate Ligament (PCL) often present subtle signs that can be challenging to detect on MRI.
  • Studies indicate that nearly 28% of chronic PCL injuries might appear almost normal, while another 44% may demonstrate continuity but with noticeable residual morphologic deformities.

2️⃣: The Role of Proton Density Imaging

  • Proton density imaging, particularly with fat suppression, is crucial for highlighting subtle pathological changes within the PCL. T
  • his technique often reveals increased intraligamentous signal intensity that might not be evident on T2-weighted images.
  • For instance, in a case where the PCL diameter and contour appeared normal on T2WI, the proton density sequence unveiled significant abnormalities leading to a correct diagnosis of 

3️⃣: The Value of Stress Radiography

  • In cases where MRI results are equivocal, stress radiographs provide an objective method to evaluate the structural integrity of the PCL.
  • By quantifying the extent of posterior tibial translation, this technique helps distinguish between partial and complete tears. Measurements show that less than 8mm of translation usually indicates a partial tear, 8-12mm a complete tear, and more than 12mm typically suggests a combined complete tear involving the posterolateral corner.

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