摘要
目的:分析膝关节后内侧结构的解剖、生物力学特点及临床意义;阐述膝关节后内侧结构的MRI正常及损伤后表现;进行后内侧结构损伤MRI分级。方法:回顾分析87例后内侧结构、以及其他相关损伤的MRI所见。结果:本组87例后内侧结构损伤,Ⅰ级损伤29例,Ⅱ级47例,Ⅲ级11例;合并交叉韧带损伤34例(39%),内侧半月板后角撕裂13例(14.5%),鹅足三肌2例(0.23%),后外侧结构损伤9例(10.3%)。因后交叉韧带部分或完全断裂行重建手术者44例,术后恢复36例(81.8%),术后6个月随访膝关节稳定性不佳例8例(18.2%)。结论:膝关节后内侧角结构复杂,对于膝关节的静态及动态稳定具有重要作用;膝关节外伤易累及后内侧角,且常伴有交叉韧带、内侧半月板损伤。熟悉后内侧角的解剖结构有助于提高MRI诊断准确率。忽略后内侧角的前交叉韧带、后交叉韧带重建术易导致术后恢复不佳或手术失败;因此,进行交叉韧带重建术前,必须对后内侧结构进行MRI观察及MRI分级评估,以确保手术的成功。MRI是诊断后内侧结构损伤最理想的影像手段,能够显示韧带及肌腱的部分断裂和完全撕裂。
Objective：To analyze the anatomical and biomechanical characteristics of posteromedial structure（PMS） of knee joint,to classify the PMS injuries findings on MRI and to reveal its clinical significance to surgical reconstruction of cruciate ligaments.Methods：MRI findings on 87 patients with PMS injuries were retrospectively analyzed.Results：Of the 87 patients with PMS injuries,29 were graded Ⅰ,47 were graded Ⅱ and 11 were graded Ⅲ.34 of 87 cases（39%） had also cruciate ligments injuries,13（14.5%） had posterior corner tear of medial meniscus,9（10.3%） had posterolateral structure injuries and 2（0.23%） had pes anserinus injuries.Forty-four patients with partial or complete cruciate ligaments tears were surgically reconstructed and of 36 of them（81.8%） recovered,while 8（18.2%） still had knock knee sign.Conclusion：PMS is complex and significantly contributes to maintain the dynamic and static stability of knee joint.PMS are easily involved in knee trauma and are frequently concomitant with cruciate ligaments injuries and medial meniscus tears.MRI diagnostic accuracy can be improved by well understanding the PMS anatomy.Cruciate ligament reconstruction procedures ignoring the PMS injury can result in poor outcomes or failures.So it is necessary to perform MRI scan and grade PMS injures before surgery.MRI is the ideal imaging modality to display PMC injuries and the concomitant partial or complete tears of tendons and ligaments.
出处
《放射学实践》
北大核心
2011年第6期645-648,共4页
Radiologic Practice
关键词
膝关节
生物力学
损伤
磁共振成像
Knee joint
Biomechanics
Injuries
Magnetic resonance imaging
