股直肌的超声解剖学特点与撕裂的声像图关系  

The sonographic anatomy of rectus femoris and its relationship with tears

作　　者：崔立刚[1] 王金锐[1] 汪海燕 林发俭[1] 傅先水[1] 贾建文[1] 张武[1] 

机构地区：[1]北京大学第三医院超声科,100191 [2]河北省秦皇岛妇幼保健院

出　　处：《中华医学超声杂志（电子版）》2009年第6期55-57,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨股直肌的超声解剖结构及其与不同部位股直肌外伤撕裂间的关系。方法应用高频超声对10例健康志愿者的股直肌(20条)进行超声扫查,采用系列长轴和短轴切面依次获得股直肌的纵断面与横断面声像图,并将声像图与解剖描述及图谱相对照分析,识别股直肌的超声解剖结构。回顾性分析2006年4月至2009年1月14例超声诊断股直肌撕裂患者的声像图资料,结合声像图解剖进行分型诊断,并经随访和临床证实。结果正常股直肌近端由直头肌腱和反折头肌腱起源。连续超声扫查显示直头肌腱参与形成浅层腱膜,反折头肌腱在近端肌腹内形成中央腱膜,中央腱膜于横断面显示清晰,呈"逗号样"高回声结构位于肌肉中央。股直肌远端肌腱参与形成股四头肌腱浅层。以此为基础,14例股直肌撕裂可分为3类,发生在远端肌肉肌腱连接处1例,肌纤维与外周腱膜连接处5例,肌纤维与中央腱膜连接处8例。结论超声检查能够显示股直肌存在特殊的解剖结构,识别其声像图特点有助于对外伤撕裂的准确定位诊断。Objective The purpose of this study was to review the sonographic anatomy of the rectus femoris （RF） and to describe its relationship with different sonographic appearance of RF tears. Methods The sonographic anatomy of RF was assessed in 10 healthy subjects（20 thighs） with series of long-axis and short-axis images. The sonographic appearances were correlated with anatomy book and atlas. A retrospective review of 14 RF tears examinations between April 2006 and January 2009 was performed and classified into different types based no healthy anatomy. All tears were confirmed by clinical data and followups. Results The RF originated from proximal direct and indirect tendon. The series of sonographie images showed the outer aponeurosis deriving from direct tendon, while the indirect tendon followed as central aponeurosis within the cranial part of the muscle which was demonstrated clearly in short-axis image as a comma- shaped hyperechoic band. The distal tendon of RF continued as the superficial layer of quadriceps tendon. By sonographic anatomy, the 14 RF tears were classified into 3 types according to location： type 1 （ 1 case） , the distal muscle-tendon junction ; type 2 （5 cases） , the fiber-outer aponeurosis junction ; type 3 （8 cases） , the fiber-central aponeurosis junction. Conclusions The sonography can demonstrate RF with special anatomic structures which could be helpful for diagnosis of RF tear location accurately location.

关 键 词：超声检查 股直肌 解剖学 撕裂伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R685[医药卫生—诊断学]