膝关节的横断层影像解剖学

Transverse sectional and imaging anatomy of the human knees

目的 :为给膝关节伤病的横断层影像学诊断提供解剖学基础。方法 :用成年男尸右膝部标本 6具 (新鲜 4、经福尔马林固定 2 ) ,先作膝关节横断层CT及MR扫描 ,冰冻后切制成 11个横断层解剖标本。结果 :观察了每一断层内各结构的形态特征、位置毗邻及其在连续断层的变化规律 ,并匹配同一断层的CT及MRI。①髌股关节显示于第 5～ 8断层 ,其关节软骨均匀一致 ,表面平整光滑 ,但关节腔形态不尽相同 ,分别呈磨合紧密狭窄凸向后的弧形 ,前后径短的横位“X”字形及前小后大相通的“工”字形。②髌韧带显现于第 9～ 11断层 ,其横断面最宽处为 2 4.6mm ,最厚处为 4.85mm。③前、后交叉韧带显示于第 8～ 11断层 ,其横断面之长、短径值 ,前交叉韧带为 7.45mm与 6.5 5mm ,后交叉韧带为 6.2 5mm与 4.12mm。④第 10断层可视为膝关节的代表断面 ,各主要辅助结构均可见 ,其中内侧半月板呈大的“C”字形。而外侧半月板呈曲度较大的小的反“C”字形 ,二者的前后角处 ,分别有前、后交叉韧带。结论 :膝关节各横断层的解剖形态、结构对医学影像学诊断有很重要的临床意义。

Objective: To provide transverse sectional anatomical basis for imaging diagnosis of the injury and disease of human knees.Methods: 6 right knees of male adults specimens(4 fresh,2 fixed by foramlin)were used.After the CT and MR imaging examination,all specimens were frozen and cut into 11 transverse sections.Results:The morphological characteristics relation and the law of variation of the articular facets of patellofemoral joint、cruciate ligaments、menisci、synovial bursae and synovial plicae on all transverse sections of knees were observed,and compared with the corresponding CT and MR images. ①The patellofemoral joint can be shown on the sections 5 50 8,having even smoothness on their cartilages,yet various shapes of their joint cavities,which feature archly backwards,The joints likes tightly and closely in the shape of “x”and “工” pattern.②The patellar ligament can be shown on the sections 9 to 11,the broadest part of which measures 24.6mm and the thichest 4.85mm.③Both the antertior and posterior cruciate ligaments can be shown on the sections 8-11,the length and the width of the transection of the former were 7.45 mm and 6.55 mm respectiveily,and those of later were 6.25mm and 4.12mm.④The transection 10 can be seen as a typical part of knee joints, for all the basic accessories and related structures can be found here.The medial menisus forms a big reversed 'C'-shaped-pattern,and while laterial a 'C'-shaped pattern,on both of whose connections,there are anterior and posterior cruciate ligaments.Conclusions:The vaviation of morphology and structures of all transverse sectional anatomy of knee joint provided foundation of dependable anatomy and clinical value for medical imaging diagnosis.