膝关节前交叉韧带损伤的MRI成像方法及诊断研究

The research on MR imaging of cruciate ligament of knee joint injury

目的:结合膝关节交叉韧带的解剖学特点及MRI表现,探寻前交叉韧带(ACL)最佳MRI成像方法、观测ACL损伤的MRI表现,为临床诊断ACL损伤提供可靠的影像学资料。方法:选择成人膝关节ACL损伤30例,分别进行膝关节伸直位、微曲位和屈曲位的快速自旋回波序列垂直矢状位和斜矢状位的MR扫描,观察不同位置、不同角度矢状面交叉韧带的显示效果及MRI表现。结果:①ACL损伤的显示:ACL损伤在伸直位垂直、斜矢状面完整显示率分别为46.7%、53.3%;微曲位垂直、斜矢状面上ACL在斜矢状面上完整显示率分别为80.0%、80.0%;屈曲位垂直、斜矢状面上ACL完整显示率分别为90.0%、90.0%。②ACL损伤的MRI表现:ACL部分性撕裂韧带中出现的局限性高信号,完全性撕裂韧带显示局限性中断或完全缺损或韧带附着处出现团状高信号影或韧带纤维难于辨认。结论:ACL在MRI上屈曲位斜矢状面显示最佳,可作为诊断前交叉韧带损伤的有效手段;ACL的形态、信号的变化对ACL损伤的诊断具有重要的指导意义。

Objective： To supply reliable imaging data for clinical diagnosis and treatment, we combine the anatomy peculiarities of cruciate ligament of knee joint with the manifestation of MR imaging in order to find best protocol for MR imaging and observe the MRI manifestation of cruciate ligament. Methods： Thirty cases of adult knee joints with injury of cruciate ligament were scanned by MRI with spin echo of sagittal surface and inclined sagittal surface knee joint in extending position, slightly bending position and bending position. The manifestation of cruciate ligament from different position and different angle in sagittal view were observed on work station. Results： ①The display of injured anterior cruciate ligament （ACL）： the complete display rate of ACL in vertical and inclined sagittal surface in extending position is 46.7% and 53.3% respectively. The complete display rate of ACL in inclined sagittal view of vertical and inclined sagittal view in slightly bending position is 80.0% and 80.0% respectively. Complete display of ACL in vertical and sagittal view of bending position is 90.0% and 90.0% respectively.②The manifestation of MRI of cruciate ligament. It＇s difficult to identify the slight high signal appeared in the partial cruciate ligament tears. In complete ligament tears it appears a break or defect in the ligament or a ball-like high signal at the attachment of the ligament. Conclusion： MRI in sagittal view of bending position was the best plane for showing ACL tear. It has a leading significance for the diagnosis and treatment in cruciate ligament injury.