前交叉韧带黏液样变性的MRI表现  

MR imaging representation of mucoid degeneration of anterior cruciate ligament

作　　者：贾佳 戴世鹏 张崇海 孙文静 JIA Jia;DAI Shipeng;ZHANG Chonghai(Chengde Medical College,Hebei,Chengde 067000,China;不详)

机构地区：[1]承德医学院,河北省承德市067000 [2]河北省沧州市人民医院磁共振室

出　　处：《河北医药》2021年第17期2629-2632,共4页Hebei Medical Journal

摘　　要：目的总结前交叉韧带黏液样变性(mucoid degeneration of anterior cruciate ligament,MD-ACL)的MR特征,探讨MD-ACL的发病机制。测量髁间窝宽度指数(NMI),讨论NWI与MD-ACL的关系。方法回顾性分析经MR检查并经关节镜手术的患者资料,从中找出28例经膝关节磁共振平扫及增强扫描诊断为MD-ACL并经关节镜证实的患者设为病例组,选取28例前交叉韧带正常的患者为对照组。2组均测量NWI值。结果病例组患者临床上均表现为膝关节疼痛和屈曲受限,在MR中显示弥漫增粗的前交叉韧带(anterior cruciate ligament,ACL)充满整个髁间窝,轮廓不清但完整,呈现典型“芹菜梗”样改变。MR增强扫描时,28例MD-ACL患者中表现出ACL边缘的中度增强20例,边缘轻度增强8例。病例组28例诊断为MD-ACL的患者中,NWI值平均为0.256,范围为0.233~0.312,SD为0.021。对照组NWI值平均为0.212,范围为0.18~0.25,SD为0.027。结论MR平扫及增强扫描可为临床诊断和治疗方式的选择提供依据,利用MRI推断MD-ACL的发病机制并测量NWI,可以认为NWI值小(髁间窝狭窄)与MD-ACL的发病关系密切。Objective To investigate the MR features of mucoid degeneration of anterior cruciate ligament(MD-ACL),and to explore the pathogenesis of MD-ACL and the correlation between femoral notch width index(NWI)and MD-ACL.Methods The data of patients who underwent MR examination and arthroscopic surgery in our hospital in recent 5 years were retrospectively analyzed,and the data of 28 patients diagnosed as MD-ACL by plain and enhanced MRI and confirmed by arthroscopy were enrolled as case group.And the other 28 patients with normal ACL were enrolled as control group.NWI values were measured in both groups.Results All the 28 patients in case group showed clinical knee pain and limited flexion,and MR showed diffuse thickened anterior cruciate ligaments(ACL)filling the entire intercondylar fossa,and outline was unclear,but it wa complete,with typical“celery stalk”changes.By the MRI enhanced scanning,20 of the 28 MD-ACL patients showed moderate enhancement of the ACL edge,and 8 cases showed mild enhancement of the edge.In case group,the mean NWI value was 0.256,ranging from 0.233~0.312,and SD was 0.021.In control group,the average NWI value was 0.212,ranging from 0.18 to 0.25,and SD was 0.027.Conclusion MR scanning and enhanced scanning can provide the basis for the selection of clinical diagnosis and treatment.By measuring NWI value,it can be concluded that the NWI value is small(stenosis of intercondylar fossa),which is closely related to the incidence of MD-ACL.

关 键 词：前交叉韧带 黏液变性 磁共振成像 髁间窝宽度指数 

分 类 号：R814.46[医药卫生—影像医学与核医学]