肘关节韧带解剖及损伤的磁共振成像表现  

Magnetic resonance imaging of ligaments in the elbow joint: normal anatomy and injuries

作　　者：张晶[1] 白荣杰[1] 詹惠荔 王崧铭 钱占华[1] 李亚雄[1] 叶薇[1] Zhang Jing;Bai Rongjie;Zhan Huili;Wang Songming;Qian Zhanhua;Li Yaxiong;Ye Wei(Department of Radiology,Peking University Fourth School of Clinical Medicine,Beijing Jishuitan Hospital,Beijing100035,China)

机构地区：[1]北京大学第四临床医学院北京积水潭医院放射科,北京100035

出　　处：《中华全科医师杂志》2022年第10期959-966,共8页Chinese Journal of General Practitioners

基　　金：国家自然科学基金面上项目(82171921,81771809);北京市自然科学基金资助项目(7202063)。

摘　　要：目的探讨肘关节韧带的正常解剖及其损伤的磁共振成像(MRI)表现。方法对2019年2月至2022年2月北京积水潭医院放射科招募的38名(38侧)健康志愿者及82例肘关节损伤患者的MRI检查影像资料进行回顾性分析。健康志愿者均无肘关节外伤、肘关节韧带损伤、疼痛史,肘关节功能正常;82例肘关节韧带损伤患者经手术证实8例、随访证实74例。采用盲法对照分析肘关节内、外侧副韧带复合体结构的正常解剖及损伤的MRI表现特点。结果38例健康志愿者的内侧副韧带复合体和外侧副韧带复合体在MRI T1加权(T1WI)与质子密度加权脂肪抑制(PD-FS)序列上均表现为细条带状低信号,环状韧带表现为包绕桡骨头的环形线样低信号。82例肘关节韧带损伤患者中,单独内侧副韧带复合体损伤6例,单独屈肌总腱损伤2例,内侧副韧带复合体伴屈肌总腱损伤4例;单独外侧副韧带复合体损伤9例,单独伸肌总腱损伤21例,外侧副韧带复合体伴伸肌总腱损伤31例;内、外侧副韧带复合体损伤9例,其中5例伴屈、伸肌总腱损伤。9例内、外侧副韧带复合体均损伤中,完全撕裂5例,部分撕裂4例;10例内侧副韧带复合体损伤中,拉伤9例,完全撕裂1例;40例外侧副韧带复合体损伤中,拉伤29例,部分撕裂10例,完全撕裂1例。MRI检查T1WI序列上拉伤的韧带表现为增粗模糊,纤维尚连续,PD-FS序列表现为信号不均匀增高;部分撕裂表现为纤维增粗、局部不连续;完全撕裂表现为中断的纤维回缩,断端韧带结构消失,伴周围软组织水肿。结论MRI是评价肘关节内、外侧副韧带复合体正常解剖及损伤的有效方法,对肘关节韧带损伤的诊断和治疗具有重要的应用价值。Objective:To explore the magnetic resonance imaging (MRI)features of the normal anatomy and injuries of ligaments in the elbow joint.Methods:Thirty-eight healthy volunteers (38 sides) and 82 patients with elbow joint injuries were recruited in the Radiology Department of Beijing Jishuitan Hospital from February 2019 to February 2022 and the MRI findings were analyzed. The healthy subjects had no history of trauma, elbow joint ligament injury or pain, and the elbow joint function was normal. Among the 82 patients with elbow joint injuries, 8 cases were confirmed by operation and 74 were confirmed by follow-up. The MRI characteristics of normal anatomy and injuries of the medial collateral ligament and lateral collateral ligament complex of the elbow were compared and analyzed by blind method.Results:The medial collateral ligament and lateral collateral ligament complex in 38 healthy volunteers showed as thin strip low signal on T1-weighted imaging (T1WI) and fat suppression proton density-weighted imaging (PD-FS), and the annular ligament showed as annular linear low signal surrounding the radial head. Among the 82 patients with elbow injuries, in the medial side, there were 6 cases with medial collateral ligament injuries alone, 2 with common flexor tendon injuries alone, and 4 with medial collateral ligament and common flexor tendon injuries;while in the lateral side, there were 9 cases with the lateral collateral ligament complex injuries alone, 21 with common extensor tendon injuries alone, and 31 with the lateral collateral ligament complex and common extensor tendon injuries. In addition, there were 9 cases of medial collateral ligament coupled with lateral collateral ligament complex injuries. Among the 9 cases of combined ligament injuries (5 cases with injuries of the common flexor or extensor tendon), 5 cases were complete tears and 4 cases were partial tears. Among the 10 cases of medial collateral ligament injuries, 9 patients were strain and one was complete tear. Among the 40 cases of lateral collate

关 键 词：肘关节 韧带 解剖 损伤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.4[医药卫生—诊断学]