拇指掌指关节侧韧带正常解剖及损伤的MRI表现

MRI of the thumb collateral ligament at the metacarpophalangeal joint：anatomy and injuries

目的 探讨拇指掌指关节侧韧带的正常解剖及损伤的影像表现.方法 选择2011年9月至2014年9月北京积水潭医院7名健康志愿者和20例拇指掌指关节侧韧带损伤患者为研究对象,所有健康志愿者及患者均行拇指侧韧带MR检查,对照分析健康志愿者与拇指侧韧带损伤患者的侧韧带正常解剖及侧韧带损伤的MRI特点.将其影像学表现与手术或随访结果进行对照,并由双盲法分析确认.结果 7名健康志愿者拇指侧韧带MRI在T1WI和质子密度脂肪抑制（PD-FS）序列上均为细条带状均匀低信号.正常尺侧副韧带的平均厚度为2.0～2.3 mm,正常桡侧副韧带更薄,平均厚度为1.4～1.5 mm.20例拇指侧韧带损伤患者（其中尺侧副韧带损伤12例,桡侧副韧带损伤8例）表现为损伤韧带T1WI序列信号不清,纤维连续性中断,PD-FS序列损伤的韧带信号不均匀增高,并可见周围软组织水肿.结论 MRI是评价拇指侧韧带正常解剖及损伤的有效方法,对拇指侧韧带损伤的早期诊断和治疗具有重要的意义.

Objective To explore the anatomy and injuries features of the thumb collateral ligamentat the metacarpophalangeal（MCP） joints.Methods The study was reviewed and approved by an institutional review board of hospital.Clinical imaging data of 7 healthy volunteers who without injuries and 20 patients with thumb collateral ligament injuries were retrospectively analyzed.All subjects underwent magnetic resonance examination,then comparative analysis of the normal anatomy and the thumb collateral ligament injury at MCP joints of MRI features in healthy volunteers and patients with injury.Imaging findings were compared with the surgical results and confirmed by followed up in patients.Results Seven volunteers without ligament injures showed homogeneous low-signal-intensity on T1-weighted and proton fat saturation sequence（PD-FS） images.The average thickness of the ulnarcollateral ligament is about 2.0 to 2.3 mm,however,the normal radial collateral ligament is thinner,the average thickness is about 1.4-1.5 mm.There were 20 patients with thumb collateral ligament injuresat MCP joints,including 12 cases of ulnar collateral ligament injury and 8 cases of radial collateral ligament injury,which demonstrated poor definition,discontinuity and heterogeneously increased signal intensity in proton fat saturation sequence（PD-FS） of the involved collateral ligament.There was edema in the soft tissues surrounding the injured sites.Conclusion MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the thumb collateral ligamentsat MCP joints,and it is a useful tool for early diagnosis and treatment of the thumb collateral ligaments injuries.