膝关节交叉韧带腱鞘囊肿的MRI分型及分析

MR Imaging of Ganglion Cysts of the Cruciate Ligaments of the Knee

目的探讨膝关节交叉韧带腱鞘囊肿的MRI分型及影像学表现。方法回顾本院放射科2012年4月至2015年4月行膝关节MRI检查的患者30049例(男14386例,女15663例),MRI诊断为交叉韧带囊肿者89例,男51例,女38例,平均年龄41岁。按部位将囊肿分为前交叉韧带、后交叉韧带及韧带间囊肿三种亚型,观察各型囊肿大小、间隔、分叶情况并进行统计分析。结果 54例(60.7%)为前交叉韧带囊肿,平均直径23.05 mm,位于股骨端27例,韧带全长者16例,胫骨端11例,40例MRI表现为韧带纤维束分离征象,即高信号囊肿穿插在连续性完整的韧带纤维束间,14例合并韧带黏液变性。24例(27.0%)为后交叉韧带旁囊肿,平均直径为13.53 mm,均位于韧带后缘。交叉韧带间囊肿为11例(12.4%),平均直径为19.53 mm,MRI表现为韧带间隙内囊样信号灶,5例囊肿向周围延伸类似哑铃状。结论前交叉韧带囊肿较其他亚型类型发病率高,不同亚型的MRI特异性表现有利于定位诊断。

Objective To investigate the MRI features of ganglion cysts of the cruciate ligaments. Methods 30049 patients （ 14386 males, 15663 females） who had MR scanning of the knee from April 2012 to April 2015 were retrospec-tively reviewed. 89 patients （51 males, 38 females） with an average age of 41 years were diagnosed with ganglion cysts of the cruciate ligaments. Cysts were divided into three groups： ACL, PCL and the space between them. Features such as location, size, internal septa and degree of lobulation of the cystic lesions were analyzed. Results 54 （ 60.7% ） cysts originated from the anterior cruciate ligament （ACL） ,with 27 located in the proximal ligament , 11 in the distal ligament and 16 in the entire ligament; separated ACL was seen in 40 examinations and mucoid degeneration of ACL was seen in 14 examinations. 24 （27.0%） cysts were located in the posterior space of posterior cruciate ligament （PCL） ; 11 （12.4%） cysts originated from the space between ACL and PCL, 5 of them had a dumbbell-like shape with a narrow neck. Conclusion ACL location was more frequent occurrence of ganglion cysts followed by PCL and the space between ACL and PCL. Identi-fication of cystic masses with fluid signal and special locations detected in MRI were helpful for diagnosis.