军事训练膝关节不同应力性损伤的高场MRI表现  

High field MRI manifestation of different stress injury of knee joint in military training

作　　者：臧建华[1] 刘建军[1] 张瑛[1] 赵云辉[1] 付明华[1] 努尔黑扎 王永峰[1] 白伟强[1] 

机构地区：[1]兰州军区乌鲁木齐总医院MR室,新疆乌鲁木齐830000

出　　处：《临床军医杂志》2014年第8期827-830,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨军事训练膝关节不同应力性损伤的特点、生物力学特征及其高场MRI表现。方法回顾性分析我院2010年12月—2012年12月军事训练膝关节应力性损伤患者的MRI资料共102个膝关节,根据应力性质及应力作用的特点、组织损伤部位及特点,对每一个膝关节的MRI资料进行分析。结果 102个膝关节中,股骨远端38例,胫骨近端42例,前交叉韧带98例,后交叉韧带31例,内侧副韧带34例,外侧副韧带24例,关节腔积液76例,内侧半月板18例,外侧半月板11例,5例为单纯型损伤,97例为复合型损伤。交变应力性损伤时MRI可见骨髓腔内线状、斑片状长T1长T2信号影;拉应力性损伤时MRI可见与骨干平行的软组织异常信号,骨髓腔内片状异常信号,有骨折时骨髓腔锯齿状、斜行或横行的长T1短T2信号影;压应力性损伤时MRI可见胫骨平台的骨髓水肿、压缩骨折、半月板损伤和软组织损伤;剪切应力性损伤时MRI可见交叉韧带、侧副韧带、半月板、股骨髁或胫骨平台的异常信号。结论军事训练膝关节应力性损伤的程度与军事活动的频度、强度和训练科目有关,军事训练膝关节所遭受的应力作用不是单一的,而是几种应力的共同作用,MRI能敏感地发现不同应力所致的组织损伤特点,对膝关节应力性损伤各期的评价和诊断具有明显的优势,能为军事训练应力性损伤的预防和早期干预提供借鉴。Objective To investigate the characteristics of biomechanics and manifestation of high field magnetic resonance imaging （MRI） of knee joint different stress injuries in military training. Methods Retrospective analysis was done on MRI data of 102 knee joints＇ stress injuries in military training between Dec. 2010 and Dec. 2012. Results Of the 102 knee joints, 38 were in- jured at distal femur, 42 at proximal tibia, 98 at anterior crueiate ligament, 31 at posterior cruciate ligament, 34 at medial collateral ligament, 24 at lateral collateral ligament, 76 at articular cavity （hydrops） , 18 at medial meniscus, and 11 at lateral meniscus ; 5 were simple type and 97 complex type. Line type, plaque shape long T1 and long T2 signal were seen in marrow cavity in MRI for ahemating stress ; abnormal signal of soft tissue parallel with diaphysis, plaque shape abnormal signal and spination, oblique type and laterigrade type long T1 and short T2 signal were seen in marrow cavity in MRI for tensile stress ; marrow edema or compression fracture of tibial plateau, meniscus injury and soft tissue injury were seen in MRI for compressive stress ; abnormal signal of cruciate ligament, collateral ligament, meniscus, femoral condyle and tibial plateau were seen in MRI for shear stress. Conclusion The degree of knee joint stress injury in military training concerned with the frequency and the intensity of military activity and training tasks. Stress role is not simplex. The characteristics of stress injuries can be seen sensitively in MRI, which helps to provide with prevention and early intervention in stress injury in military training.

关 键 词：军事训练 膝关节 应力性损伤 磁共振检查 

分 类 号：R445.2[医药卫生—影像医学与核医学]