膝关节韧带损伤的MRI诊断价值

目的:探讨膝关节韧带损伤的MRI特点与诊断价值。方法:收集2008年6月至2010年2月经MRI检查的74例膝关节损伤患者,男47例,女27例;年龄12～76岁,平均37.3岁;病程2h～10d。临床表现为膝关节肿胀、疼痛,关节不稳、伸屈活动障碍,外翻试验、抽屉试验阳性,膝内侧明显压痛。对其MRI表现进行回顾性分析。结果:74例韧带损伤,其中前交叉韧带19例,后交叉韧带18例,外侧副韧带13例,内侧副韧带24例。韧带完全断裂12例,其中8例交叉韧带MR表现为韧带的连续性中断、断端回缩,局部或弥漫性肿胀,PDWI上呈中等信号,T2WI和脂肪抑制序列呈高信号;4例侧副韧带MR表现为韧带连续性中断或韧带肿胀增粗,PDWI上呈中等信号,T2WI和脂肪抑制序列呈高信号。部分纵形撕裂62例,MR表现为韧带连续性完整,韧带增粗,PDWI上呈中等信号,T2WI和脂肪抑制序列呈高信号。经手术、关节镜检查确诊44例,与MRI诊断相符41例。结论:MRI能诊断膝关节韧带损伤,是一种理想的诊断膝关节外伤的检查方法,宜作为常规检查。

The value of MRI in diagnosis of ligament injuries of knee joint

Objective: To study the performance of MRI and its diagnostic value for ligament injuries of knee joint. Methods: Form June 2008 to February 2010,the MRI of 74 patients with ligament injuries of knee joint were retrospectively analyzed. There were 47 males and 27 females in the group,which course was from 2 h to 10 d,with an average age of 37.3 years (ranged from 12 to 76). The clinical symptom included knee swelling,pain,joint instability,extension-flexion movement disorder. The physical examination showed valgus test or drawer test positive,and tenderness of medial knee positive. Results: There were ligament injuies in 74 cases,among them,19 cases were anterior cruciate ligament (25.7%),18 were posterior cruciate ligament (24.3%),13 were lateral collateral ligament (17.6%),24 were medial collateral (32.4%),the ligament of 12 cases were completely broken(included 8 cases cruciate ligament and 4 cases collateral ligament presented as discontinued signals of the ligament,and swelling and thickening of the ligament with medium signal in PDWI and high signal intensity in T2WI and in SPIR). The MRI of 62 patients with partial longitudinal tearing ligaments showed continuity,swelling and thickening of the ligaments with medium signal in PDWI and high signal intensity in T2WI and in SPIR. Forty-four cases were examined with surgery and arthroscopy,41 ligaments were accorded with MRI,diagnosis rate of MRI was 95%. Conclusion: MRI can accurately diagnose the ligament injuries of knee joint,which is an ideal technique in the diagnosis of ligament injuries of knee joint,and should be used as a routine examining method.