膝关节韧带损伤的MRI诊断价值  

The diagnosis of MRI of ligament injuries of knee joint

作　　者：尹京春[1] 林达[1] 黄晓辉[1] 蔡庆虎[1] 邱乾德[1] 

机构地区：[1]浙江省温州市第三人民医院影像科,浙江温州325000

出　　处：《医学影像学杂志》2011年第3期418-421,共4页Journal of Medical Imaging

摘　　要：目的：探讨膝关节韧带损伤的MRI表现特点。方法：回顾性分析50例损伤的膝关节韧带的MRI表现。结果：本组50例87根韧带损伤,其中前交叉韧带15根（17.2%）,后交叉韧带18根（26.7%）,外侧副韧带15根（17.2%）,内侧副韧带39根（44.8%）。50例中复合韧带损伤16例37根,其中前交叉＋后交叉＋外侧副韧带3例9根,前交叉＋后交叉＋内侧副韧带2例6根,前交叉＋内侧副韧带3例6根,后交叉＋内侧副韧带3例6根,后交叉＋外侧副韧带3例6根,前交叉＋外侧副韧带2例4根。单一韧带损伤34例50根,其中前交叉韧带5根,后交叉韧带7根,外侧副韧带7根,内侧副韧带31根。韧带完全横断撕裂7根,其中前交叉韧带1根,后交叉韧带2根,内侧副韧带3根,外侧副韧带1根。87根中部分纵行撕裂80根;7根完全断裂中3根交叉韧带MRI表现为韧带的连续性中断,断端回缩,局部或弥漫性肿胀,PDWI上呈中等信号,T2WI和脂肪抑制序列呈高信号;4根侧副韧带MRI表现为韧带连续性中断或韧带肿胀增粗,PDWI上呈中等信号,T2WI和脂肪抑制序列呈高信号。80根部分纵行撕裂MRI表现为韧带连续性完整,韧带增粗,PD-WI上呈中等信号,T2WI和脂肪抑制序列呈高信号。经手术关节镜检查21例33根,与MRI诊断相符31根,不符合2根,符合率为93.9%。54根经保守治疗后30~40天MRI复查见韧带原异常高信号而恢复至正常低信号,韧带形态类似正常,33根经关节镜下行韧带重建修复术,30~40天MR复查见原异常高信号而恢复至正常低信号,但局部成角或形态仍不规则。结论：MRI对软组织有极高的分辨率,不仅能较清楚显示膝关节韧带损伤,并能显示半月板损伤和骨挫伤,具有较高的实用价值。Objective：To study the characteristics of MRI findings of ligament injuries of knee joint.Methods：MRI appearances of injuied knee ligament in 50 cases were retrospectively reviewed.Results：There were 87 ligament injuied in 50 cases,inculding15 anterior cruciate ligament（17.2%）,18 posterior cruciate ligament（26.7%）,15 lateral collateral ligament（17.2%）,39 medial collateral（44.8%）.There were 37 compound ligament injured in 16 cases,inculding ACL＋PCL＋LCL in 9 of 3 cases,ACL＋PCL＋MCL in 6 of 2 cases,ACL＋MCL in 6 of 3 cases,PCL＋MCL in 6 of 3 cases,PCL＋ LCL in 6 of 3 cases,ACL＋LCL in 4 of 2 cases.A signal ligament was injured in 50 of 34 cases,including 5 ACL,7 PCL,7 LCL,31 MCL.Completely fracture in 7 root： MRI finding of continuity moderate and retraction of end,swelling in local and diffuse resistance,medium signal up PDWI and high signal in T2WI and SPIR of 3 root cruciate ligament;displayed discontinuity,swelling and thickening of the ligaments with medium signal in PDWI and high signal intensity in T2WI and in SPIR of 4 root collateral ligament.80 partial longitudinal teared ligaments displayed continuity,swelling and thickening of the ligaments with medium signal in PDWI and high signal intensity in T2WI and in SPIR.28 ligaments in 15 cases were examined with surgery and arthroscopy,26 ligaments were checked with MRI,and 2 ligaments were not correspond with MRI.59 ligaments were reviewed on MRI displaying normal low signal,and the ligament morphology was similar to the normal on conservative treatment.28 ligaments with arthroscopic reconstruction were reviewed on MRI after 30~40 days displaying normal low signal,but with irregular shape or local angulation.Conclusion：MRI has extremenly high resolution of the soft tissues,only can more clear that the knee joint ligament injury,also can showed the menisus injury and the bone contusion,practical value have higher.

关 键 词：膝关节 韧带损伤 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R445.2[医药卫生—外科学]