儿童盘状半月板损伤机制和3.0T MRI表现分析

Analysis of the 3.0T MRI Manifestations of Discoid Meniscus Injury in Children and Their Mechanism

目的:探讨儿童盘状半月板及损伤3.0TMR影像特征。方法:回顾性分析经关节镜证实的28例儿童盘状半月板3.0TMR影像资料,全部为单膝患病。临床表现为膝关节肿胀、疼痛,关节伸直受限及疼痛,部分出现跛行,11例患者存在外伤史。本组病例均行3.0TMR常规矢状面T1WI,T2WI,质子密度抑脂序列,和横断面及冠状面T2WI序列扫描。结果:28例儿童盘状半月板3.0TMR影像特点按Hall分型:24例表现为任何一种类型盘状半月板伴撕裂(Ⅵ型);2例为双凹型(Ⅱ型);1例为板状型(Ⅰ型);1例为顿挫型(Ⅴ型)。24例盘状半月板损伤中2例为Ⅱ度损伤,4例为Ⅲ度损伤,18例为Ⅳ度损伤。关节镜下所见:完全型21例;不完全型4例;Wrisberg韧带型3例。结论:3.0TMR能够显示儿童盘状半月板及不同程度损伤有助于患儿及早诊治。

Objective：To study the features of discoid meniscus （DM） injury in children with 3.0T MR scan for clinical diagnosis and treatment. Methods： 3.0T MRI materials of 28 cases with arthroscopy proved DM injury were retrospectively analyzed. All of them had unilateral lesion. The clinical manifestations included swelling, pain, limitation of knee extension with various degree, snapping of knee joint, some patients had claudieation. 11 cases had history of injury. All patients underwent routine 3.0 MR scanning with sagittal plane images of T1W,T2 W and PD fat-suppressed sequences,coronal and axial images of T2W sequence. Results： According to Hall classification of DM injury, these 28 pediatric patients with DM were classified as follows：any type of DM with tearing （type Ⅵ, 24 patients） ,hi concave lens-like meniscus （type Ⅱ ,2 patients）, plate-like thickening （type Ⅰ , 1 patient） and abortive type （type Ⅴ, 1 patient）. Of the 24 patients with DM tearing, there were Ⅱ° tearing in 2 patients, Ⅲ° tearing in 4 patients, Ⅳ° tearing in 18 patients. According to arthroseopy findings, 21 cases were complete type, 4 cases were incomplete type and 3 cases were Wrisberg ligament type. Conclusion： Various types of DM injury in children as well as their degree could be demonstrated by 3.0T MR scanning,which is helpful to obtain accurate diagnosis and treatment in time.