基于MRI的膝内侧半月板后角根部损伤及伴发损伤  

Posterior medial meniscus root ligament lesions of knee joint and its associated injury based on MRI

作　　者：王军凯 赵本琦 王先道 郑卓肇[1] WANG Jun-kai;ZHAO Ben-qi;WANG Xian-dao(Department of Radiology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院放射科,清华大学临床医学院,北京102218

出　　处：《放射学实践》2022年第7期880-883,共4页Radiologic Practice

摘　　要：目的:了解膝关节MR检查患者内侧半月板后角根部(PMMRL)损伤的发生率,探讨PMMRL的各种损伤类型以及伴发损伤。方法:收集3241例膝关节MRI图像(男1257例,女1984例,年龄2~97岁,平均年龄51岁),统计PMMRL损伤的发生率,分析PMMRL损伤的类型以及同时合并的内侧半月板撕裂、内侧半月板脱出、内侧半月板后角根部附着点处骨髓水肿、自发性骨坏死(SONK)、前交叉韧带(ACL)损伤以及软骨损伤等发病情况。结果:膝关节PMMRL损伤全部发生于50岁以上的人群;PMMRL损伤发生率为6.1%(198/3241):退变1.2%(40/3241),部分撕裂1.8%(58/3241),完全撕裂3.1%(100/3241);半月板后角根部撕裂的病例中,放射状撕裂占35.4%(56/158)。PMMRL损伤的伴发损伤中,内侧半月板撕裂占40.9%(81/198);内侧半月板脱出64.1%(127/198);内侧半月板后根部附着点处骨髓水肿47%(93/198);自发性骨坏死(SONK)11.6%(23/198);前交叉韧带(ACL)变性12.6%(25/198),ACL撕裂5%(10/198);内侧股胫间室、外侧股胫间室及髌股间室软骨损伤Ⅲ~Ⅳ级(ICRS分级)分别占70.3%(139/198)、34.9%(68/198)、70.7%(140/198)。结论:膝关节内侧半月板后角根部损伤的发生率为6.1%左右,常发生于50岁以上的人群;内侧半月板后角根部损伤常合并邻近结构的损伤。Objective:To investigate the incidence of posterior medial meniscus root ligament(PMMRL)lesions on knee MRI,and to explore various types of PMMRL lesions and the findings of associated injuries.Methods:3241 cases of knee MRI images were reviewed(1257 male,1984 female;aged from 2 to 97 years,mean age was 51 years).The incidence of PMMRL lesions was calculated,the types of PMMRL lesions were classified and analyzed,and concomitant signs such as medial meniscal tear,medial meniscal extrusion,bone marrow edema at the attachment point of the PMMRL,spontaneous osteonecrosis(SONK),anterior cruciate ligament(ACL)injury and cartilage lesion were also analyzed.Results:All the PMMRL lesions of the knee occurred in people over 50 years old.The incidence of PMMRL lesions was 6.1%(198/3241):degeneration 1.2%(40/3241),partial tears 1.8%(58/3241),and complete tears 3.1%(100/3241).Radial tears accounted for 35.4%(56/158)of all cases.Of the concomitant injuries of PMMRL injury,medial meniscus tears accounted for 40.9%(81/198).Medial meniscus extrusion 64.1%(127/198).Marrow edema at the posterior root attachment point 47%(93/198);SONK 11.6%(23/198);ACL degeneration 12.6%(25/198),ACL tear 5%(10/198);Chondral wear(gradeⅢandⅣ)on the internal femoral tibial compartment,lateral femoral tibial compartment and patellofemoral compartment respectively 70.3%(139/198),34.9%(68/198)and 70.7%(140/198).Conclusion:The incidence of PMMRL lesions of the knee was about 6.1%,most of which occurred in people over 50 years old.PMMRL lesions were often associated with injuries of adjacent structures.

关 键 词：膝关节 内侧半月板 后角根部损伤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684.76[医药卫生—诊断学]