膝后主要血管神经束的MRI定位及临床意义  

The clinical significance of MRI positioning of the major popliteal neurovascular bundle

作　　者：谢能峰[1] 苏伟[1] 李尚政[1] 郭杰[1] 何肖丞[1] 唐成[2] 

机构地区：[1]广西医科大学第一附属医院创伤骨科手外科,南宁530021 [2]广西医科大学第一附属医院放射科,南宁530021

出　　处：《广东医学》2013年第9期1359-1361,共3页Guangdong Medical Journal

摘　　要：目的通过MRI了解膝后主要血管神经束(包括腘动脉、腘静脉、胫神经)在膝关节后的空间位置,为临床膝部手术避免发生重要结构副损伤提供影像学依据。方法选择行膝关节MRI检查的患者100例,排除膝后软组织病变及关节腔内大量积液等影响膝后组织的病例,在膝关节面及胫骨选取有代表性的平面,分别测量血管神经束到半月板、胫骨后方皮质及两侧骨皮质的距离,从而划定相对安全的手术区域。结果膝后重要血管神经束在膝关节后方主要走行偏外侧,离胫骨后皮质很近,其中在关节面下(8.75±2.11)mm有一段长(6.98±1.83)mm的血管神经束离胫骨最近,距离为(2.85±1.09)mm。结论把胫骨平台等分成4个柱,中外侧柱为危险手术区,该柱从膝关节面往下(8.75±2.11)mm,长(6.98±1.83)mm为危险手术区域。Objective To study the location of the popliteal major neurovascular bundle （NB, including the pop- liteal artery, popliteal vein and tibial nerve） by magnetic resonance images （MRI）, thus to provide imaging support for popliteal operation. Methods Knee MRI examinations were performed in 100 patients for the study. The inclusion crite- ria were： （1） no knee soft tissue lesions; （2） no intra -articular effusion. The distances between the NB and the meniscuses, posterior cortex, and both sides of the cortical bone of the tibia were measured. The safe surgical field was defined with data analysis. Results NB ran partial laterally in popliteal region, closed to the posterior tibial cortex, which was closest inferior the knee joint by （8. 75 ±2. 11 ） ram, with the mean distance of （2. 85 ± 1.09） mm and a length of （98 ± 1.83） mm. Conclusion The tibial plateau is divided into four columns, the lateral column is considered as the dange- rous surgery area. A area length （6. 98 ±1.83） mm and （ 8.75 ± 2. 11 ） mm inferior from the plateau is considered as a dangerous area.

关 键 词：血管神经束 膝关节 手术安全区域 磁共振成像 

分 类 号：R782.22[医药卫生—口腔医学]