手指屈肌结构正常解剖及损伤的磁共振表现  

MR imaging of flexor tendon and pulley system of the fingers： normal anatomy and injury

作　　者：白荣杰[1] 詹惠荔 刘悦[1] 张恒[1] 钱占华[1] 叶薇[1] 李亚雄[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33期2604-2608,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项目（2016-2-1122）

摘　　要：目的探讨手指屈肌结构正常解剖及损伤的磁共振（MRI）表现。方法选择2013年3月至2016年3月问，20名健康志愿者的手指屈肌结构解剖和北京积水潭医院36例屈肌结构损伤患者的临床及影像学资料。所有志愿者和患者均行MR检查，将损伤患者与健康志愿者屈肌结构的MRI表现进行对照，并将损伤患者屈肌结构的影像表现与手术结果进行对照，由双盲法分析确认。结果20名志愿者手指屈肌腱的MRI表现为细条带状均匀低T1WI、低PDFS信号。36例手指屈肌结构损伤患者（其中屈肌腱损伤21例，滑车损伤10例，屈肌腱损伤联合滑车损伤5例）主要表现为损伤结构T，WI信号不清、连续性中断，PDFS信号不均匀增高，损伤周围可见软组织水肿。结论MRI是评价手指屈肌结构正常解剖及损伤的有效方法，对手指屈肌结构损伤的诊断和治疗具有重要的意义。Objective To explore the magnetic resonance imaging （MRI） features of the anatomy and injuries of flexor tendon and pulley system of the fingers. Methods Clinical and imaging data of 20 healthy volunteers without injuries and 36 patients from Beijing Jishuitan Hospital with flexor tendon and pulley system injuries in the fingers between March 2013 and March 2016 were retrospectively analyzed. All subjects underwent magnetic resonance imaging （ MRI ） examination. The MRI findings of patients were compared with healthy volunteers. In addition, imaging findings of patients were compared with the surgical results and confirmed by double-blinded method. Results Twenty volunteers without flexor tendon and pulley system injures showed homogeneous hypointensity on both Tl-weighted and Proton Density-weighted images with fat saturation （PD-FS）. There were 36 patients with finger injures, including 21 cases of flexor tendon injury, 10 cases of pulley system injury, 5 cases of compound injury, which demonstrated unclear signal, discontinuity on Tl-weighted images and heterogeneously increased signal intensity of the involved structures on PD-FS images. Edema was detected in the soft tissues surrounding the injured sites. Conclusions MRI is an accurate method for evaluation of the anatomy and pathologic conditions of flexor tendon and pulley system of the fingers and a useful tool for diagnosis and treatment of flexor tendon and pulley system injuries.

关 键 词：手指 解剖学 损伤 磁共振成像 屈肌 滑车 

分 类 号：R445.2[医药卫生—影像医学与核医学] R658.2[医药卫生—诊断学]