MRI在腘绳肌损伤中的应用价值

Application value of MR imaging in hamstring injuries

目的:探讨MRI在腘绳肌损伤中的应用价值。方法:14例腘绳肌损伤患者行MRI检查,分析损伤部位和累及范围、肌腱形态改变、肌束是否中断、出血、羽毛样水肿及肌间积液等征象,并根据肌肉和肌腱的连续性对损伤程度进行分级。结果:本组中发生肌腱损伤者3例(3/14),肌肉损伤者11例(11/14)。肌腱损伤均位于腘绳肌近端肌腱,其中1例为完全断裂。肌肉损伤全部位于肌肉-肌腱连接处,其中6例发生于股二头肌,3例发生于半膜肌,2例发生于半腱肌。14例腘绳肌损伤中,肌间积液(11/14)和羽毛样水肿(11/14)为较常见的影像表现,3例可见肌肉内出血。14例中Ⅰ级损伤3例,Ⅱ级损伤10例,Ⅲ级损伤1例。结论:腘绳肌最严重的损伤是近端肌腱的完全断裂,肌肉拉伤均发生于肌腱-肌肉连接处且好发于股二头肌;羽毛状水肿、肌间积液、波浪状肌腱和肌束中断是其特征性的影像表现。MRI能准确评估腘绳肌损伤的严重程度。

Objective:To study the application value of MRI in hamstring injuries.Methods:Fourteen patients with clinically diagnosed hamstring injuries underwent MRI examination.Analysis of injury site and extent of involvement,changes in tendon morphology,interruption of muscle bundles,hemorrhage,feather-like edema,and intermuscular effusion were analyzed.According to the continuity of muscle and tendon,the severity of the hamstring injury was evaluated.Results:In 14 patients with hamstring injury,there were 3 cases(3/14)with tendon injury and 11 cases(11/14)with muscle injury.Tendon injuries were located in the proximal hamstring tendon,one of which were completely avulsion.All muscle injuries were located at the intramuscular musculotendinous junction.Among them,6 cases occurred in biceps femoris,3 cases in semi-membranous muscle and 2 cases in semi-tendinosus muscle.The perifascial effusion(11/14)and feather-like edema(11/14)were the main manifestations,and intramuscular hemorrhage was shown in 3 cases.Among the 14 cases,3 cases were grade Ⅰ,10 cases were grade Ⅱ,and one case was grade Ⅲ.Conclusion:The most serious injury of the hamstring muscle is complete avulsion of proximal tendon.Muscle strain commonly occurs at the musculotendinous junction,especially in the biceps femoris.The perifascial effusion,feather-like edema,muscle fascicle and adjacent tendon discontinuity are characteristic features of muscle strain.MRI can accurately evaluate the severity of the hamstring injury.