腘肌半月板纤维束各向同性三维快速自旋回波MRI的应用

Objective To investigate the effect of slice orientation on the popliteomeniscal fasciculi (PMF) MR imaging and its normal MRI appearances. Methods Volumetric MRI data of 40 knees of healthy volunteers were acquired using an isotropic 3D turbo spin echo (TSE) MR sequence. The posterior tangential line to both femoral condyles was used as the reference line, and the long axis sectional images of the popliteal hiatus region were reformatted at 0°, 15°, 30°, 45°, 60°, 75° and 90° to the reference line. The MRI appearances of the PMF were scored respectively and classified. The final scores of the PMF at each slice angle were statistically analyzed by a repeated measure ANOVA. Results At 0°, 15°, 30°, 45°, 60°, 75° and 90° slice angles: scores of the anteroinferior fasciculi were (1.7±0.7), (1.8±0.6), (1.9±0.6), (2.0±0.7), (1.9±0.7), (1.8±0.8) and (1.0±0.5),respectively. Scores of the posterosuperior fasciculi were (1.5±0.7), (1.9±0.7), (2.1±0.6), (2.2±0.6),(2.2±0.6), (2.0±0.8) and (1.7±0.8), respectively. There were statistically significant differences in the average scores at each slice angle for both anteroinferior fasciculi (F = 29.744, P = 0.000) and posterosuperior fasciculi (F = 19.770,P =0.000). The anteroinferior fasciculi and the posterosuperior fasciculi had highest average scores at the angle of 45°. The percentage of type A, B and C of anteroinferior fascicali were 20.0% (8/40), 75.0% (30/40) and 5.0% (2/40), respectively. The percentage of type A, B and C of posterosuperior fasciculi were 37.5% (15/40) ,62.5% (25/40) and 0% (0/40) ,respectively. Conclusion The anteroinferior fasciculi and the posterosuperior fasciculi can be well depicted at the angle of 45° slice orientation.     

膝关节半月板损伤的MRI诊断

目的 回顾性研究膝关节半月板不同程度损伤的MRI表现。方法 对手术或临床证实的20例共31个损伤的半月板进行回顾性MRI分析。结果 在20例40个半月板中有31个损伤的半月板，其中单纯内侧损伤4个，单纯外侧损伤3个，两侧半月板同时损伤12例24个。将31个损伤的半月板按Stoller的4级分法分类，其中0级0个，Ⅰ级7个，Ⅱ级11个，Ⅲ级13个。17例出现并发症，其中半月板囊肿1例，内侧副韧带损伤3例，外侧副韧带损伤1例，前后交叉韧带同时损伤2例，内外侧副韧带前后十字交叉韧带同时损伤2例，骨折3例，关节囊积液17例。结论 MRI是一种无创伤性的能准确诊断半月板损伤并进行分级，还能发现多种并发症的成像方法。     

膝关节半月板损伤的MRI诊断及分类

半月板损伤是膝关节紊乱最常见的原因之一。磁共振检查是目前最敏感最准确的检查方法，面且对半月板撕裂的类型能做出较准确的判断。     

膝关节半月板损伤的MRI诊断

目的：探讨膝关节半月板损伤的MRI临床诊断价值。方法：回顾性分析108例膝关节半月板损伤的MRI表现。并按Mink和Fischer方法进行分级。结果：108例216个半月板中有159个损伤，其中I级损伤36个，Ⅱ级损伤78个。Ⅲ级损伤45个(经手术证实)。结论：MRI对膝关节半月板损伤具有很高的诊断价值及临床意义，可以清晰地显示半月板的形态、位置及其信号的变化，为临床治疗提供可靠的依据，是目前诊断半月板损伤最好的检查方法。     

MRI在腘绳肌损伤中的应用价值

【摘要】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。     

膝关节半月板囊肿22例MRI分析

目的：分析膝关节半月板囊肿的MRI特点，提高对该病的认识。方法：回顾性分析22例膝关节半月板囊肿的MRI表现并与关节镜或手术结果对照。探讨半月板囊肿发生的部位、形态、信号特征及与半月板的毗邻关系。结果：22例半月板囊肿中，内侧半月板囊肿4例(18．1％)，外侧半月板囊肿18例(81．8％)。22例半月板囊肿中显示半月板水平撕裂15例(68．2％)，纵行撕裂3例(18．1％)。结论：半月板囊肿好发于外侧半月板，并与半月板的撕裂相关，表明MRI对诊断半月板囊肿有较高的临床价值。     

膝关节半月板及其损伤的MRI研究

目的　研究正常和损伤的膝关节半月板的MRI表现。方法　对经手术、关节镜或临床证实的 2 6例共 3 2个损伤的半月板与 15例正常的膝关节半月板进行回顾性MRI对比观察。结果　显示正常膝关节半月板在T1WI和T2 WI上均呈三角形低信号。 3 2个损伤的半月板 ,其中内侧损伤 15个 ,外侧损伤 11个 ,两侧半月板同时损伤 3例 6个 ,将 3 2个损伤的半月板按Stoller的 4级分法分类 ,其中 0级 0个 ,I级 6个 ,Ⅱ级 12个 ,Ⅲ级 14个。 18例出现并发症 ,其中合并半月板囊肿 6例 ,内侧副韧带损伤 10例 ,外侧副韧带损伤 9例 ,前交叉韧带损伤 7例 ,后交叉韧带损伤 6例 ,骨挫伤 8例 ,骨折 5例 ,关节囊积液 11例 ,膝关节周围软组织内瘀血 6例。结论　MRI能够清晰显示膝关节半月板的解剖结构 ,能准确诊断半月板的损伤并进行分级 ,还能发现多种并发症。     

MRI超短回波时间序列评价膝关节半月板的研究进展

半月板是膝关节的重要结构,MRI超短回波时间（UTE）序列相比传统MRI序列能够直接采集短T₂/T₂*信号,不仅能够定量测量半月板,还能够显示半月板胶原纤维及钙化成分,区分半月板红白区,以及评估半月板pH值等。简要介绍UTE序列,并就其在半月板中的研究进展予以综述。     

膝关节半月板囊肿的MRI特点

目的 探讨半月板囊肿的MRI特点及流行病学特点.方法 对489例膝关节半月板囊肿的发病率、性别、年龄、囊肿的大小、分布、性状及合并半月板撕裂等进行统计,分析半月板囊肿分型与半月板撕裂、撕裂类型及年龄的关系.结果 半月板囊肿的发病率为1.92％,男、女性别无明显差异.内、外侧半月板囊肿的发生比率为1:2.15;外侧半月板囊肿多发生于前角、体部,内侧多发生在后角;根据半月板囊肿的MRI表现分为4型:半月板旁型、半月板内型、滑膜型和混合型;本组病例中合并半月板撕裂者占94.7％,滑膜型半月板囊肿合并半月板撕裂比率明显低于其他类型;半月板囊肿分型与半月板撕裂类型无统计学相关,各型半月板囊肿均以水平撕裂最多见.本组半月板囊肿按年龄分为≤19岁、20～50岁、≥51岁3组,年龄与半月板囊肿分型无统计学相关,在各年龄阶段,半月板旁型半月板囊肿最多见.结论 半月板囊肿多发生于外侧半月板,外侧半月板囊肿多见于前角、体部,内侧多见于后角,常合并半月板撕裂;滑膜型半月板囊肿合并半月板撕裂比率明显低于其他类型;各型半月板囊肿均以水平撕裂最多见;在各年龄阶段,半月板旁型半月板囊肿最多见.     

膝关节半月板病变的低场MRI的临床应用

膝关节是人体最大且构造最复杂、损伤机会较多的关节。MRI以其高软组织对比、无创伤、无并发症已成为骨关节检查的理想手段[1],在国内外已被广泛用于膝关节病变的诊断。笔者对2007年6月～2009年6月的47例膝关节半     

MRI of the popliteomeniscal fasciculi

OBJECTIVE: The purpose of this study was to further our understanding of the normal appearance of the popliteomeniscal fasciculi (PMF) on MRI after the determination of finely tuned imaging parameters. For this purpose we performed the study in two stages. Stage I was to determine suitable parameters for depicting the popliteomeniscal fasciculi. Stage II was to classify the "normal" image. CONCLUSION: The findings presented in this article will contribute to the understanding of the normal appearance of the popliteomeniscal fasciculi on MRI, and of the degree of variation of this structure among the population.     

Fat-suppressed volume isotropic turbo spin echo acquisition (VISTA) MR imaging in evaluating radial and root tears of the meniscus: Focusing on reader-defined axial reconstruction

Objective

To assess the diagnostic value of fat-suppressed (FS) three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) imaging in detecting radial and root tears of the meniscus, including the reader-defined reformatted axial (RDA) plane.

Materials and methods

Twenty-three patients with arthroscopically confirmed radial or root tears of the meniscus underwent magnetic resonance imaging (MRI) with 2D and FS 3D VISTA sequences. MRIs were reviewed independently by two musculoskeletal radiologists blinded to the arthroscopic findings. Sensitivity, specificity, accuracy, and interobserver agreement were calculated for radial and root tears. Both radiologists reported confidence scale for the presence of meniscal tears in 2D axial imaging, 3D axial imaging, and RDA imaging, based on a five-point scale. Wilcoxon's signed rank test was used to compare confidence scale.

Results

The sensitivity, specificity, and accuracy of FS 3D VISTA MR imaging versus 2D MR imaging were as follows: 96%, 96%, and 96% versus 91%, 91%, and 91%, respectively in reader 1, and 96%, 96%, and 96% versus 83%, 91%, and 87%, respectively, in reader 2. Interobserver agreement for detecting meniscal tears was excellent (κ = 1) with FS 3D VISTA. The confidence scale was significantly higher for 3D axial images than 2D imaging (p = 0.03) and significantly higher in RDA images than 3D axial image in detecting radial and root tears.

Conclusions

FS 3D VISTA had a better diagnostic performance in evaluating radial and root tears of the meniscus. The reader-defined reformatted axial plane obtained from FS 3D VISTA MR imaging is useful in detecting radial and root tears of the meniscus.     

利用快速自旋回波序列测量骨骼肌肉系统的T2时间

目的 评价利用快速自旋回波序列(TSE)对骨骼肌肉系统进行单层和多层T2值定量的可行性.方法 (1)利用钆喷替酸葡甲胺溶液和磷酸盐缓冲液配制出8管不同T2值的钆溶液,以多回波自旋回波序列(MSE)测量的T2值作为对照标准,评价TSE序列进行单层和多层(层间距为50%)T2测量的可靠性.(2)在6名志愿者活体膝关节中,对比MSE和TSE序列测量T2值的一致性.结果 (1)在模型中,除纯磷酸盐缓冲液(T2值约2000 ms)外,其余7管溶液TSE的T2测量值(89.9±3.0)～(1228.0±128.0)ms与MSE的T2测量值(89.6±1.0)～(1221.0±18.0)ms,差别＜10%.但TSE测量的标准误有所增大.(2)在模型中,当溶液的T2值＜1000 ms时,TSE多层面T2测量值(85.8±5.0)～(902.7±354.0)ms与单层面T2测量值(89.9±3.0)～(930.0±71.0)ms,差别＜10%.但是,对于T2值＞1000 ms和T2值约为600 ms的溶液,两者的差别＞10%.(3)在志愿者膝关节中,对于除黄骨髓外的其余各组织,MSE、TSE单层和TSE多层的T2测量值(51.5±15.4)～(476.5±69.7)ms具有非常好的一致性(ICC＞0.75).结论 利用TSE序列进行单层面和多层面T2值定量具有可行性.但是,对于骨髓组织和极长T2值的组织(如脑脊液),利用TSE序列测量T2值可能会有较大的偏差.     

Evaluation of turbo spin echo sequences for MRI of focal liver lesions at 0.5 T

To determine whether turbo spin echo (TSE) sequences can replace conventional T2-weighted spin echo (SE) sequences in MRI of the liver, 40 patients with focal liver lesions were imaged at 0.5 T. A T2-weighted SE sequences (TR/TE 1800/90 ms, number of signals averaged [NEX]=2, scan time=7:16 min), a TSE sequence (TR/TE 1800/90 ms, NEX=4, number of echos per excitation=13, echo spacing=12.9 ms, scan time=4:16 min) and a T1-weighted SE sequence (TR/TE 350/15 ms, NEX=2, scan time=4:21 min) were obtained and image quality, lesion detectability and lesion differentiation were evaluated qualitatively by subjective assessment using scores and quantitatively by lesion-liver contrast-to-noise (CNR) and tumour/liver signal intensity (SI) ratios. The image quality of the TSE sequence was substantially better compared with the T2-weighted SE sequence due to a reduction in motion artefacts and better delineation of anatomical details. Of a total of 158 visible lesions the T1-weighted SE, TSE, and T2-weighted SE sequences showed 91%, 81% and 65% of the lesions, respectively. Thus the TSE sequence depicted 24% (P< 0.001) more lesions than the T2-weighted SE sequence. In all types of pathology the lesion-liver CNR of the TSE sequence was significantly (P< 0.001) higher compared to the CNR of the T2-weighted SE sequence (+ 55–65%), indicating superior lesion conspicuity. Lesion characterization was equally good on the two T2-weighted sequences with no difference in the tumour/liver SI ratio. Using a criterion of tumour/liver SI ratio equal to or higher than 2, haemangiomas larger than 1 cm in diameter could be differentiated from other lesions with a sensitivity and specificity of 95% and 96%, respectively. Our results indicate that the TSE sequence is suitable for replacing the conventional T2-weighted SE sequence in MRI of focal liver lesions.This paper was presented at ECR 1993 Correspondence to: B. Kreft     

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。     

膝关节损伤的MRI诊断

目的：探讨膝关节损伤的MRI特点、病理基础及临床意义。方法：分析52例膝关节损伤的MRI资料。结果：半月板损伤45例,MRI表现为黑色的半月板内出现结节状、线状、放射状裂隙样异常高信号,延伸达或未及关节软骨面两种,前交叉及后交叉韧带损伤24例,MRI表现为在条索状黑色韧带影中出现短T1长T2异常高信号,韧带变形,呈波浪状或不连续,胫骨移位,内、外侧副韧带损伤28例,表现为信号增高,形态增粗,边缘模糊,隐匿性骨折8例,表现为干骺端边界模糊的片状T1低信号影,T2信号多样,讨论：MRI对膝关节半月板、韧带损伤及隐匿性骨折的诊断有重要的临床意义,可对治疗方案的选择提供详尽的依据。     

MRI在膝关节软骨病变中的应用及研究进展

膝关节是人体最大最复杂的关节,关节软骨在维持关节正常活动中起到重要作用。关节软骨病变是影响膝关节稳定性的重要因素。磁共振成像（magnetic resonance imaging,MRI）对诊断膝关节软骨病变具有良好的空间分辨率和组织对比度,是目前评价关节软骨病变最有效的无创技术,其在膝关节疾病诊断中的应用日益广泛并显示出独特的优势。     

人体正常半月板MRI三维定量测量及临床意义

目的:探讨应用MRI测量国人半月板正常量值范围,为诊断半月板疾病和半月板移植提供客观依据.材料和方法:采用四肢专用关节MRI成像系统,对57只膝关节正常半月板的前角、体部和后角进行高度和宽度的测量,还对胫骨平台的宽度进行测量.结果:内侧半月板前角、体部、后角的宽度和高度分别为7.74±1.41mm和4.48±0.77mm,8.43±1.91mm和4.49±0.72mm,10.89±2.22mm和5.50±1.01mm.外侧半月板前角、体部、后角的宽度和高度分别为8.96±2.06mm和4.28±0.70mm,9.18±2.12mm和4.74±0.90mm,9.64±2.26mm和5.56±0.86mm.外侧半月板体部宽度与胫骨平台宽度比例为13.97%.结论:本研究所获国人体内MRI测量的正常数据,对诊断半月板疾病和半月板移植有重要参考价值.     

膝关节外伤的低场MRI诊断

目的 分析膝关节外伤后的MRI表现并探讨低场强MRI在膝关节外伤中的诊断价值。方法 对经临床或手术证实的53例膝关节外伤患者行低场MRI检查，分析、总结其MRI表现。采用0．3T低场MR扫描机，常规应用冠状位和矢状位SE序列，GRE序列及脂肪抑制STIR序列T1WI，T2WI成像。结果 半月板损伤37例，韧带损伤43例，骨挫伤7例，骨折11例，合并关节积液25例，多种损伤可同时出现。结论 低场MRI可以很好显示膝关节损伤的各种表现，可作为膝关节外伤后检查的首选或重要手段。