手指肌腱韧带的磁共振成像技术及临床应用  

MRI of the f＇mger ligament and tendon injuries： imaging technique and clinical application

作　　者：李亚雄[1] 叶薇[1] 白荣杰[1] 詹惠荔 刘悦[1] 钱占华[1] 张恒[1] 

机构地区：[1]北京积水潭医院放射科,北京市创伤骨科研究所,100035

出　　处：《中华医学杂志》2017年第11期847-851,共5页National Medical Journal of China

基　　金：国家自然科学基金面上项目（81371515）;北京市自然科学基金面上项目（7142075）;首都卫生发展科研专项（首发2016-2-1122）

摘　　要：目的研究手指肌腱韧带的磁共振成像（MRI）技术及临床应用价值。方法经伦理审查委员会批准，选取2012年5月至2015年5月北京积水潭医院20名健康志愿者及50例手指损伤的患者进行手指MRI检查，采用荷兰飞利浦公司Achieva3.0T超导MR扫描仪进行轴位、冠状位及矢状位扫描，选择T1WI和质子密度脂肪抑制（PD-FS）序列进行扫描，选择合理的参数得到手指肌腱韧带的清晰影像。结果20名健康志愿者手指肌腱韧带在T1WI和PD-FS序列均表现为均匀的细条带状低信号。50例手指外伤患者中，侧副韧带损伤患者33例，伸肌腱损伤10例，屈肌腱损伤7例。在所有手指损伤的病例中有8例同时伴有指骨或掌骨骨折。损伤的韧带及肌腱在T1WI序列显示纤维增粗、模糊、连续性不佳，PD-FS序列上信号不均匀增高，周围可见软组织水肿。 结论MRI技术可精确显示手指肌腱韧带的精细解剖结构及损伤的影像学表现，对损伤的早期诊断与治疗方案的制定具有重要价值。ObjectiveTo explore the MRI technique and the clinical application in ligament and tendons of fingers.MethodsThe study was reviewed and approved by an institutional review board of hospital.A total of 20 normal volunteers and 50 patients from Beijing Jishuitan Hospital between May 2012 and May 2015 with finger injuries were chosen to undergo magnetic resonance examination by using Achieva 3.0 T MR produced by Philips.Scanning from coronal, sagittal and axial view in T1-weighted and proton fat saturation sequence （PD-FS）, choosing suitable parameters, in order to get clear images of finger tendons and ligaments.ResultsTwenty normal volunteers without tendons or ligament injuries showed homogeneous low-signal-intensity on T1-weighted and proton fat saturation sequence （PD-FS） images.In the 50 patients with finger injuries, there were 33 cases of ligament injuries, 10 cases of extensor tendon injuries and 7 cases of flexor tendon injuries. There were 8 cases of all the 50 cases combined with bone fracture.The injured ligaments and tendons became thicker and discontinued in T1WI and demonstrated heterogeneously increased signal intensity with edema in the soft tissues surrounding the injured sites in PD-FS. ConclusionMRI can demonstrate the anatomy and injuries features of ligament and tendons in fingers accurately.It is significance for the early diagnosis and treatment protocols of the ligament and tendons injuries.

关 键 词：磁共振成像 手指 肌腱 韧带 损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]