膝关节交叉韧带囊肿的MRI表现及诊断价值

目的:探讨膝关节交叉韧带囊肿的MRI表现,评价MRI对交叉韧带囊肿的诊断价值。方法:收集我院2010年1月～2012年3月8例经手术或关节镜摘除、病理证实的交叉韧带囊肿患者的影像资料,总结交叉韧带囊肿的MRI影像学特点。结果:8例中,均为单膝发病,其中左膝5例,右膝3例;位于前叉韧带近端7例,后交叉韧带表层1例;囊肿呈圆形、球型1例,卵圆形或浅分叶状5例,弥漫型2例。结论:MRI对交叉韧带囊肿的显示有明显优势,能够显示囊肿的大小、形态、部位、与周围结构的关系,术前能够作出明确诊断,可指导治疗,有重要的临床应用价值。     

膝关节交叉韧带损伤的MRI诊断

目的 :探讨MRI对膝关节交叉韧带损伤的诊断价值。方法 :回顾性分析 2 5例经手术或关节镜证实的前、后交叉韧带损伤患者 ,MR检查采用SE、TSE矢状位、冠状位及横断位T1WI、T2 WI及STIR。结果 :2 5例交叉韧带损伤中 ,部分性撕裂 16例 ,完全性撕裂 9例。MRI诊断交叉韧带部分性撕裂和完全性撕裂的符合率分别为 87.5 %和 88.9%。结论 :MR能较准确地诊断膝关节交叉韧带损伤及其并发症 ,为临床制订治疗方案提供可靠依据。     

高场磁共振对膝关节前交叉韧带损伤的诊断价值

目的研究高场磁共振（MR）对膝关节前交叉韧带损伤的诊断价值,为临床治疗提供可靠的依据。方法采用Siemens1．5T超导MR机,回顾性分析46例患者（前交叉韧带58例）的超导MR检查结果．分析前交叉韧带损伤的MR异常信号特点并观察前交叉韧带解剖学特点,与膝关节镜结果进行对比。结果58例前交叉韧带中,不全性撕裂32例,完全性撕裂26例。高场超导MR诊断前交叉韧带不全性撕裂和完全性撕裂与关节镜吻合率约为91％和100％。结论高场MR诊断膝关节前交叉韧带损伤的准确率高,能够为临床治疗提供很好的参考依据。     

交叉韧带腱鞘囊肿的MRI诊断

目的探讨交叉韧带腱鞘囊肿的MRI表现及诊断价值。资料与方法对5例经手术证实的交叉韧带腱鞘囊肿患者的MRI表现进行回顾性分析。结果5例中,2例前交叉韧带囊肿和3例后交叉韧带囊肿。均为单发囊肿,长径介于12～34mm之间,呈圆形或分叶状、纺锤状等,边缘光滑,分界清晰,其间常见线样分隔,与交叉韧带关系密切。较大者病变主体位于交叉韧带周围,较小囊肿走行于韧带之间。呈长T1、长T2液体信号,相邻关节囊可受压、变形,相邻骨质表现有退行性改变。结论膝关节交叉韧带腱鞘囊肿非常少见,临床表现常缺乏特异性,MRI检查有助于明确诊断,并为进一步治疗提供重要信息。     

膝关节韧带损伤的MRI诊断

目的:探讨膝关节韧带损伤的MRI表现及诊断价值。方法:36例临床怀疑膝关节损伤的患者于关节镜及手术前行MRI检查,以关节镜结果作为金标准,前瞻性分析膝关节韧带损伤的MRI表现及诊断价值。结果:关节镜证实前交叉韧带损伤21例,其中完全撕裂15例,部分撕裂6例,后交叉韧带损伤12例,正常患者15例。MRI诊断前交叉韧带损伤的敏感度为95.2%,特异度为80%,准确度为88.9%;诊断后交叉韧带损伤的敏感度为100%,特异度为95.8%,准确度为97.2%。结论:MR1是诊断膝关节韧带损伤的理想检查方法,具有较高的临床应用价值。     

膝关节韧带损伤的MRI诊断

目的 探讨膝关节韧带损伤的MRI表现及诊断价值. 方法 回顾性分析32例经手术或关节镜检查证实的膝关节韧带损伤的MRI资料,所有病例均行常规MRI扫描,对疑有前交叉韧带损伤的患者,加扫斜矢状位T_2WI像,对疑有胫侧副韧带损伤的患者加扫冠状脂肪抑制T_2WI像. 结果 32例膝关节中MR诊断韧带损伤共36条,其中前交叉韧带损伤16条,后交叉韧带损伤14条,胫侧副韧带损伤5条,腓侧副韧带损伤1条.韧带损伤包括韧带完全撕裂和部分撕裂. 结论 MRI 是理想的诊断膝关节韧带损伤的无创性检查方法.     

膝交叉韧带腱鞘囊肿的MRI表现

目的:探讨膝关节前、后交叉韧带腱鞘囊肿的MRI特征。方法:回顾性分析经关节镜或病理证实的21例交叉韧带腱鞘囊肿的临床及膝关节MRI资料。由4位主治医师以上职称的影像学医生分别进行独立读片并记录病变的部位、形状、大小及信号变化。结果:21例患者中,MRI显示囊肿位于前交叉韧带(ACL)14例(韧带内11例,前缘3例),位于后交叉韧带(PCL)5例(均位于其后缘),2例位于ACL与PCL之间区域。21例囊肿大小9.6～47.3mm,其中呈条片样8例、椭圆形6例,有分隔4例,边缘分叶3例。MRI表现为液体信号特征,TSE T1WI呈低信号或中等低信号,T2WI及STIR呈高信号。结论:MRI能准确判断交叉韧带腱鞘囊肿的位置、大小和形状,有助于关节镜术计划的制定。     

可吸收界面螺钉及腘绳肌腱重建前交叉韧带疗效分析

目的探讨关节镜下应用可吸收界面螺钉及腘绳肌腱对陈旧性膝关节前交叉韧带损伤的患者进行重建的临床疗效。方法对15例陈旧性前交叉韧带损伤患者行关节镜下重建手术,术后均随访1年,比较术前、术后膝关节稳定性、自觉症状、关节功能等,用Lysholm中的八项评分标准进行对比。结果 14例患者重建后膝关节的活动度及稳定性良好,1例差,优良率93.3%。结论关节镜下可吸收界面螺钉结合腘绳肌腱重建前交叉韧带是治疗陈旧性前交叉韧带的可靠术式,能够近期恢复膝关节的功能。     

前交叉韧带重建术后胫骨骨道囊肿的诊断和治疗(附5例报告)

目的:探讨前交叉韧带重建术后胫骨骨道囊肿的发生原因和诊治方法。方法:通过对我所1909例行前交叉韧带重建手术患者的随访发现,5例胫骨骨道囊肿,其中男性4例、女性1例,患者平均年龄22.4岁(17～28岁)。在前交叉韧带重建术后20.6个月(17～30个月),患者发现胫前皮肤隆起伴不同程度的疼痛,其中4例实施手术治疗,完整切除囊肿。结果:手术治疗患者,术中均发现胫前囊肿与骨道相通,囊内有透明胶冻样物质,术后随访10个月(2～14个月),疼痛症状消失,无一例复发。结论:胫骨骨道囊肿的发生可能与移植物选择、制备及固定方式等因素有关。手术切除囊肿效果明确,症状消失无复发。     

关节镜下韧带重建术治疗膝关节交叉韧带断裂

目的：采用关节镜下韧带重建术治疗膝关节交叉韧带断裂,探讨与分析临床治疗效果。方法研究共纳入对象40例,均为2011年12月～2013年12月收治的膝关节交叉韧带断裂患者,所有患者均实施关节镜下韧带重建术治疗,对患者进行6个月左右的随访,观察患者治疗前后的Lysholm评分、IKDC2000膝关节主观功能评分与关节活动度进行观察。结果与治疗前相比,两组在Lysholm评分、IKDC2000膝关节主观功能评分与关节活动度上均得到了改善,差异显著具有统计学意义（ P＜0．05）;40例患者当中,有26例膝关节功能优,12例良,2例差,优良率为95％。结论对于膝关节交叉韧带断裂患者来说,运用关节镜下韧带重建术治疗可起到显著的效果,创伤小,并发症少,价格低廉,能加快患者的关节活动速度,值得推广。     

Ganglion cysts of the cruciate ligaments

Purpose:
To evaluate the MR findings of ganglion cysts of the cruciate ligaments in correlation with clinical findings. Material and Methods:
We reviewed 12 patients with ganglion cysts of the cruciate ligaments obtained from a medical record of 4153 consecutive patients referred for knee MR examinations. All patients presented with chronic knee pain and 4 had restriction of knee motion. The MR imaging findings of the cysts were evaluated and correlated with clinical manifestations. Results:
Seven ganglion cysts were found in the posterior cruciate ligaments and 5 in the anterior cruciate ligaments. All cysts were lobulated (n=7) or fusiform (n=5) in shape, 1.8-4.5 cm in size, along the posterior surface in the proximal or distal end of the ligaments. Ten patients had arthroscopic resection or aspiration of their cysts, became symptom free and had no recurrence on follow-up MR examinations. Two cysts reduced in size spontaneously by conservative treatment. Conclusion:
MR imaging can offer useful information in detection and diagnosis of patients with chronic knee pain due to ganglion cysts of the cruciate ligaments. The size and location of the ganglion cysts can attribute to the clinical manifestations.     

The prevalence and significance of cyst-like changes at the cruciate ligament attachments in the knee

Approximately 1% of the total population referred for magnetic resonance imaging (MRI) of the knee at our facility have cystic changes at or near the attachment of the anterior or posterior cruciate ligaments (ACL, PCL). Cases were collected prospectively from a group of 1710 consecutive knee MR examinations, and a retrospective study analyzed the typical appearance of these cysts and any associated findings. Although most of the cysts were an incidental finding, two were associated with significant adjacent marrow edema.     

Pericruciate fat pad of the knee: anatomy and pericruciate fat pad inflammation: cadaveric and clinical study emphasizing MR imaging

Objective

The pericruciate fat pad is located in the intercondylar fossa, intimate with the cruciate ligaments. With MR imaging, signal abnormality of the pericruciate fat pad has been observed in patients with posterior knee pain. The purpose of this study was to describe the anatomy of the pericruciate fat pad in cadaveric specimens and to document the clinical spectrum of pericruciate fat pad inflammation.

Materials and Methods

Twelve cadaveric knees underwent MR imaging with T1 and T2 multiplanar images. Cadaveric sections were then prepared for macroscopic evaluation, with additional histologic analysis performed in four cases. MR images in seventeen patients (ten males, seven females; average age, 31.5?years; age range, 19–57?years) involved in intensive sporting activity and with posterior knee pain were reviewed.

Results

MR images in cadaveric specimens showed a fat pad that was located above and between the cruciate ligaments, near their attachment sites in the inner portion of the femoral condyles, within the intercondylar fossa. Fatty tissue covered by a thin layer of synovial membrane was confirmed at histology. Seventeen patients with posterior knee pain and without gross cartilage, meniscal, or ligamentous abnormalities all revealed an increased signal in this fat pad in fluid-sensitive fat-suppressed images, mainly in the sagittal and axial planes. In eight cases, enhancement of this fat pad was demonstrated following intravenous gadolinium administration.

Conclusions

The pericruciate fat pad is a structure located in the intercondylar fossa, intimate with both the anterior and posterior cruciate ligaments. Inflammatory changes in this fat pad may be found in patients, especially athletes with posterior knee pain.     

膝关节后内侧结构生物力学意义及损伤的MRI表现

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MRl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...     

膝关节韧带损伤的MRI诊断

目的：分析膝关节韧带损伤的MRI表现及诊断价值。资料与方法：回顾性分析22例经手术或关节镜检查证实的膝关节韧带损伤的MRI资料。结果：22例膝关节损伤患者中，共有37条韧带损伤，MRI检出其中的34条，其敏感性为91．9％，准确性为95．5％。交叉韧带损伤的MRI表现为韧带连续性中断，局灶或弥漫性肿胀，信号强度增加及断端移位。侧副韧带损伤的MRI表现为韧带连续性中断和／或韧带肿胀增粗，信号升高。结论：MRI是诊断膝关节韧带损伤的理想的非创伤性检查方法。     

膝关节损伤的MRI诊断及其临床价值

目的：研究膝关节损伤的MRI特点、病理基础、诊断价值及其临床意义。材料与方法：回顾性分析42例经手术病理证实的膝关节损伤的MRI资料。结果：42例膝关节损伤患者中，半月板撕裂34例，MRI表现为黑色的半月板内出现异常信号，其中延伸至关节面（26例）；“水桶把手”样撕裂（4例）；半月板变形缩小（4例）。前交叉韧带损伤28例，MRI表现为黑色条索状无信号韧带影中出现异常信号，呈不连续弯曲波浪状、斑片状或团块状。后交叉韧带损伤4例。其他改变：半月板囊肿4例，侧副韧带损伤18例，关节积液38例，骨折7例。结论：MRI对膝关节损伤的诊断具有重要的临床意义，可为制定正确的治疗方案提供客观而详细的依据。     

Computed tomography of the cruciate ligaments.

Computed tomography was used to delineate the cruciate ligaments of the knee joint in 31 patients. Optimal positioning for demonstrating the length and body of the anterior and posterior cruciate ligaments is described and the CT, arthrographic, surgical, and clinical findings are correlated. The potential and limitations of CT and its role in combination with double-contrast arthrography in the clinical setting are discussed.