| 膝关节外侧半月板假撕裂MRI征象分析及临床意义 |
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Received:April 17, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王蓼 |
WANG Liao |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
m13586925689@163.com |
| 江凯 |
JIANG Kai |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 成科 |
CHENG Ke |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 叶如卿 |
YE Ru-qing |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 吴元华 |
WU Yuan-hua |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 邓生德 |
DENG Sheng-de |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 汪建华 |
WANG Jian-hua |
宁波大学医学院附属医院影像科, 浙江 宁波 315020 |
Deptartment of Diagnostic Radiology, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年28卷，第7期，第669-672页 |
| DOI：10.3969/j.issn.1003-0034.2015.07.021 |
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目的:明确板股韧带及膝横韧带所致外侧半月板假撕裂的发生机制,探讨外侧半月板假撕裂与真撕裂的鉴别方法。
方法:对自2012年6月至2014年2月间72例(左膝44例,右膝28例)经关节镜证实的无外侧半月板撕裂的膝关节进行矢状及冠状位MR扫描,其中男41例,女31例;年龄25～61岁,平均33.7岁。观察板股韧带及膝横韧带的MRI表现。
结果:膝横韧带与外侧半月板前角及其中央腱性附着部之间以脂肪组织分隔,在MRI矢状像上,可见脂肪组织在膝横韧带与外侧半月板前角之间形成的线样稍高信号裂隙,类似外侧半月板前角撕裂,称为外侧半月板前角假撕裂。板股韧带在矢状像上表现为位于后交叉韧带前或后方的类圆形或短棒状低信号结构,而在冠状像上表现为自外侧半月板后角至股骨内侧髁外侧面的条带样低信号结构。在矢状像上,板股韧带与外侧半月板后角之间显示出一线样高信号,称为外侧半月板后角假撕裂。膝横韧带在MRI上的出现率约34.7%(25/72),表现为外侧半月板前角假撕裂18例,均表现为外侧半月板形态规则、撕裂线斜行,矢状位图像可连续显示膝横韧带,冠状位图像能显示该韧带的长轴。板股韧带显示率为73.6%(53/72),其中板股前韧带为23.6%(17/72),板股后韧带为70.8%(51/72),两条韧带同时存在为16.7%(12/72).表现为外侧半月板后角假撕裂25例,假撕裂仅有两种走行方向,即后下斜行(19/25)或垂直方向(6/25).
结论:根据外侧半月板形状、撕裂线方向、观察矢状和冠状位图像,可正确区分外侧半月板的真、假撕裂。 |
| [关键词]:膝关节 膝横韧带 板股前韧带 板股后韧带 磁共振成像 |
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| MRI ainalysis of the pseudo-tears of the lateral meniscus of the knee and its clinical significance |
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Abstract:
Objective: To determine the mechanism of pseudo-tears of the lateral meniscus caused by the transverse geniculate ligament(TL) and the miniscofemoral ligament(MFL),and to investigate a method to differentiate pseudo-tears from true tear of the lateral meniscus.
Methods: Form June 2012 to February 2014,MR examinations of 72 knees (44 left knees and 28 right knees) without tear of the lateral meniscus verified by arthroscopy were performed in the sagittal and coronal plane.There were 41 males and 31 females in the group,with an average age of 33.7 years old(ranged from 25 to 61). The MR appearance of the TL and the MFL was carefully observed.
Results: There existed fatty tissue in the gap between the TL and the anterior horn of the lateral meniscus and its central tendinous attachment. On the sagittal images,the fatty tissue formed a linear high-signal cleft between the TL and the anterior horn of the lateral meniscus. This might be mistaken as an oblique tear within the anterior horn of the lateral meniscus. It was called as pseudo-tears of the anterior horn of the lateral meniscus. In sagittal plane,the MFL was identified as a circle-like or short stick-like area of low signal intensity anterior or posterior to the posterior cruciateligament. Nevertheless,a belt-shaped area of low signal intensity from the posterior horn of the lateral meniscus to lateral facet of the medial femoral condyle was identified in the coronal plane. A linear area of high signal intensity between the MFL and the lateral meniscus was found in sagittal plane,which might be mistaken as an oblique tear within the posterior horn of the lateral meniscus. It was called pseudo-tears of the posterior horn of the lateral meniscus. The occurrence rate of the TL was 34.7%(25/72). The prevalence of pseudo-tears of the anterior horn of the lateral meniscus was 18 cases. The shape of the anterior horn of the lateral meniscus was regular,and the course of the pseudo-tears cleft was oblique. The occurrence rate of the MFL was 73.6%(53/72),which included the anterior MFL 23.6%(17/72),the posterior MFL 70.8%(51/72) and the two ligaments coexisted 16.7% (12/72). The prevalence of pseudo-tears of the posterior horn of the lateral meniscus was 25 cases. All observed pseudo-tears had either in posteroinferiorly oblique direction(19/25) or in vertical direction (6/25).
Conclusion: Based on the location and direction of pseudo-tears and observation in the continuous sagittal plane and the coronal plane,pseudo-tears is easily differentiated from the true tear of the lateral meniscus. |
| KEYWORDS:Knee joint Transverse geniculate ligament Anteriormenisco femoral ligament Poteriorminiscofemoral ligament MRI |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王蓼,江凯,成科,叶如卿,吴元华,邓生德,汪建华.膝关节外侧半月板假撕裂MRI征象分析及临床意义[J].中国骨伤,2015,28(7):669~672 |
| 英文格式: | WANG Liao,JIANG Kai,CHENG Ke,YE Ru-qing,WU Yuan-hua,DENG Sheng-de,WANG Jian-hua.MRI ainalysis of the pseudo-tears of the lateral meniscus of the knee and its clinical significance[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(7):669~672 |
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