膝关节侧副韧带及其损伤的MRI研究

The collateral ligaments: normal and pathologic appearances on MRI

目的 研究正常和损伤的膝关节侧副韧带的MRI表现。方法 对经手术或临床证实的 32例共 36条损伤的侧副韧带与 5 6例正常膝关节进行回顾性MRI对比观察。结果 正常胫、腓侧副韧带在T1和T2 WI上均呈扁平条状低信号结构 ,平均长度分别为 6 8cm和 5 7cm。 36条侧副韧带损伤 ,单纯胫侧副韧带损伤 18条 ,单纯腓侧副韧带损伤 12条 ,两侧侧副韧带同时损伤 3例 6条。Ⅰ级侧副韧带损伤 18条 ;Ⅱ级侧副韧带损伤 11条 ;Ⅲ级侧副韧带损伤 7条。2 5例 (78%)出现并发症 ,其中前交叉韧带损伤 13条、后交叉韧带损伤 9条、半月板损伤 12个 ,骨挫伤和骨折 7例 ,关节囊积液2 0例。结论 MRI能清楚显示膝关节侧副韧带解剖结构 ,能准确诊断侧副韧带损伤并进行分级 ,还能发现多种并发症 ,宜列为膝关节外伤的常规检查。

Objective To evaluate the MR findings of normal and abnormal collateral ligament. Methods The MR findings of 56 normal and 36 surgically confirmed injured collateral ligaments were retrospectively reviewed and compared. Results The normal tibial and fibular collateral ligaments were hypointense string on both T 1 and T 2 coronal MR images, with an average length of 6.8 cm for tibial collateral ligament and 5.7 cm for fibular collateral ligament. 36 collateral ligaments were injured, including 18 tibial and 12 fibular collateral ligaments. Three cases (6 ligaments) had both tibial and fibularcollateral ligaments injuries. The injury of collateral ligament was classified as: Grade I (18 ligaments), Grade Ⅱ (11 ligaments), and Grade Ⅲ (7 ligaments). The complications of anterior cruciate ligament sprains (13 cases), posterior cruciate ligament sprains (9 cases), meniscal tears (12 cases), bony contusion and fracture (7 cases), and joint effusion (20 cases) were found in 25 patients(78%). Conclusion Coronal MR imaging can clearly demonstrate the structure of the knee collateral ligaments, accurately diagnose and classify the ligament injury, and correctly detect the complications. MRI should be used as a routine examining method for knee trauma.