低场MRI在膝关节退行性骨关节病中的诊断价值

目的探讨低场MRI对膝关节退行性骨关节的诊断价值。方法对经手术、关节镜或临床证实的60例(65个)膝关节退行性骨关节病的低场MRI表现进行回顾性分析。结果低场MRI能较好地显示膝关节关节软骨、半月板、骨质及韧带等变性、损伤,较传统X线检查有明显优势。结论低场MRI对膝关节退行性骨关节病的诊断有重要价值。     

膝关节软骨退行性损害的MRI诊断

膝关节是人体最大的承重关节之一，发生退行性骨关节病的概率很高，作为退行性骨关节病的首发病变，MRI对关节软骨病变的诊断有独特的优势，笔者对60例72个慢性损伤膝关节患者进行了MRI检查，分析了软骨关节面损伤的MRI征象，以探讨MRI诊断膝关节软骨退行性损害的能力。     

膝关节软骨退行性损害的MRI诊断

膝关节是人体最大的承重关节之一，发生退行性骨关节病的概率很高、作为退行性骨关节病的首发病变，对关节软骨病变的诊断有独特的优势，笔者对60例72个慢性损伤膝关节患者进行了MRI检杏，分析了软骨关节面损伤的MRI征象，以探讨MRI诊断膝关节软骨退行性损害的能力。     

膝关节退行性骨关节病的MR诊断

目的：研究ＭＲＩ对诊断膝关节退行性骨关节病的能力和意义。材料和方法：分析３７例３８个膝关节退行性骨关节病的ＭＲＩ表现，并与平片、关节镜或手术结果进行对照。结果：ＭＲＩ能较为准确地显示骨关节病的关节软骨、半月板、韧带、滑膜、游离体及骨质的改变，明显优于平片，与关节镜检查结果基本一致，且能显示关节镜不易发现的软骨、半月板的早期退变。结论：由于ＭＲＩ信号特点与关节镜和病理分级结果一致，这就为术前正确诊断及手术方案的制定提供了确切的依据。     

MRI和X线摄影检查膝关节退行性骨关节病的临床应用分析

目的探讨MRI在膝关节退行性骨关节病诊断中的应用临床效果。方法将我院2014年~2016年收治给予治疗的膝关节退行性骨关节患者100例,随机分成观察组(MRI检查)和对照组(X线检查),分析两种检查方式的检查结果。结果 MRI检查组的准确率明显高于X线检查组,两种相比差异具有统计学意义(P0.05)。结论膝关节退行性骨关节病的患者,X线检查是早期诊断的基础,MRI检查可以检测出X线显示不出的病变类型。     

正常膝关节半月板及关节软骨的低磁场MRI表现

目的:研究正常膝关节半月板及关节软骨的低场MRI表现。材料和方法:选择膝关节无外伤史、无任何临床症状的志愿者28例,按照不同的年龄分为3组。MRI显示正常半月板及关节软骨的外形、信号强度。冠状位T1WI,最厚层面,测量半月板体部厚度;矢状位T1WI,最厚层面,测量半月板前、后角及关节软骨厚度。结果:MRI显示半月板外形均为三角形,厚度随年龄和位置的不同有差异,半月板SET1WI均见不到达关节面的条状高信号。关节软骨的厚度随年龄发生变化,但信号均匀,边缘光整。结论:正常膝关节半月板及关节软骨的厚度随年龄而发生变化,低场MRI半月板内可见线条状高信号,应避免对半月板损伤的误诊。     

X线、CT、MRI三种技术诊断退行性膝关节炎的临床价值

目的通过对比分析退行性膝关节炎X线、CT和MRI的影像学表现,为临床诊治退行性膝关节炎提供参考依据。方法回顾性分析在我院术前同时进行X线、CT和MRI检查,并经临床手术或关节镜证实的90例退行性膝关节炎的影像学资料,并加以比较。统计学方法采用SPSS 19.0处理软件,对计数资料做百分比和卡方检验,设置P0.05有统计学意义。结果 X线平片能够直接显示膝关节骨质增生、胫骨髁间嵴的变尖以及关节关系的改变;CT在X线显示征象的基础上,还可以显示关节内的钙化和游离体,对部分半月板变性也能显示,MRI在显示早期骨质增生、钙化不如X线和CT,对关节内较小游离体显示不够清楚,但对滑膜、韧带、透明软骨、软骨下骨改变较X线和CT更有优势。结论对于退行性膝关节炎,主要还是要根据病史及全面系统的骨科检查,三种影像学技术互补长短,X线平片可以作为初步筛查;CT及MRI可为临床治疗提供更精细的信息。     

盘状半月板42例的磁共振成像诊断分析

盘状半月板又称为盘状软骨．其发育异常、形态呈宽的盘状．容易发生半月板撕裂及囊肿,外侧半月板多见,易引起软骨磨损及剥脱性骨软骨炎。磁共振成像（MRI）检查是一种无创性的检查方法,能很好地显示骨质、半月板和韧带的形态和病变。回顾分析在我院进行膝关节检查并经手术或关节镜证实的42例盘状半月板的MRI图像,观察其形态及信号特征,以提高MRI诊断盘状半月板的确诊率。     

《实用临床MRI诊断图解》出版:探讨CT与核磁共振(MRI)诊断膝半月板和关节软骨损伤的临床价值

人体当中十分复杂且重要的一个生理结构就是膝关节.组成膝关节的主要结构组织包括:肌腱、半月板、关节及骨组织等其中,在关节表面当中覆盖的一种透明软骨组织就是关节软骨,其主要作用为维持关节的正常活动;软骨组织的表面特别光滑,且表现出轻微的淡蓝色.但是关节软骨十分容易因为剧烈性的运动而发生受损.在剧烈运动后发生半月板损伤的风险及比率十分大,如果半月板被撕裂或发生变性之后,会导致关节液渗入到纤维软骨当中,进而使得游离氢质子含量增加,影响关节的正常活动.对半月板及关节软骨损伤进行及时有效的早期诊断时,可给予患者使用保守治疗方法进行治疗,进而使得患者的临床症状得以缓解,甚至患者能够康复.但是假如不能给予患者进行及时的诊断,就会延误患者的病情,情况严重的甚至出现不可逆性的严重损伤.因此,半月板及关节软骨损伤的临床早期诊断,对改善患者预后具有十分重要的临床积极意义.近几年以来,伴随着临床中不断发展的影像学设备及技术,各种影像学检查方式开始在临床中快速发展并得到逐渐广泛的应用,其中常用的两种检查方式就是CT检查及磁共振成像(MRI)检查,在临床各种不同疾病的诊断中都广泛应用.因为CT检查及MRI检查都存在其不同的优点及缺点,因此,所以为了确保能给予半月板及关节软骨损伤患者进行及时的早期诊断,本文将结合《实用临床MRI诊断图解》一书探讨用CT与核磁共振(MRI)诊断膝半月板和关节软骨损伤的临床价值.     

MRI对急性膝关节骨挫伤的临床应用价值

目的：探讨MRI对急性膝关节骨挫伤的临床应用价值。方法：对117例X线平片显示阴性并行MRI检查的外伤性膝关节病例进行回顾性分析,MRI检查时间为外伤后2h．5天,重点观察股骨下端、胫腓骨上端及髌骨的骨质信号,前后交叉韧带、内外侧副韧带、内外侧半月板的完整性和信号情况。结果：急性外伤后骨挫伤的发生率为87．2％（102／117）,合并韧带损伤62例,半月板损伤49例,关节软骨损伤17例,隐性骨折21例。结论：急性膝关节外伤后骨挫伤的发生率较高,MRI能准确显示骨挫伤的部位、范围以及临近结构的损伤,对临床诊断、治疗具有重要意义。     

MRI and arthrography in the evaluation of TMJ disorders

Arthrosis of the temporomandibular joint (TMJ) is a noninfectious, noninflammatory condition characterized by joint pain, noise (clicking) and abnormal motion. It contains various disease processes, such as abnormalities in the menisci or masticating muscles, subluxation of the condyle and degenerative joint disease. Analysis of the morphology and dynamics of TMJ by means of imaging modalities has become highly advanced since the development of arthrography in the late 1970s. Magnetic resonance imaging (MRI) has become the modality of choice in the evaluation of TMJ owing to the development of surface coils. We retrospectively studied MRI and inferior joint compartment arthrography in the evaluation of TMJ disorders. Nineteen joints of 14 patients included 15 with internal derangement, two with osteoarthrosis and two normal joints. Sagittal MR images were routinely obtained in a resting position and in positions with the mouth half open, and also with the mouth fully open on balanced images. Although perforation of the menisci was difficult to evaluate, MRI and arthrography were equally useful in identifying the shape and position of the meniscus. However, MRI was more reliable in depicting TMJ abnormalities than arthrography. MR is considered to be the modality of choice in screening arthrosis of TMJ, making the definitive diagnosis of internal derangement and monitoring conservative therapy for arthrosis.     

膝关节损伤的MR应用价值

目的 :分析膝关节损伤的MR表现并评价其应用价值。方法 :选择 60例经临床或手术证实的膝关节损伤患者 ,回顾性分析、总结其MR表现。采用 1 .0TMR扫描机 ,常规应用矢状位 ,SET1 W、T2 W ,冠状位T1 W、T2 W成像。结果 :2 9例半月板损伤 ,其中Ⅰ° 1 0例 ,Ⅱ°1 2例 ,Ⅲ°7例 ;前交叉韧带损伤 1 8例 ,撕裂 2 2例 ;后交叉韧带损伤 7例 ,撕裂1例 ;内侧侧副韧带损伤 2 8例 ,撕裂 1 7例 ;外侧侧副韧带损伤 1 2例 ,撕裂 9例 ;韧带损伤表现为韧带不同程度增粗 ,但韧带连续性仍然存在 ,正常低信号内出现不规则高信号影 ,韧带撕裂表现为韧带明显增粗 ,呈弥漫性高信号 ,韧带的连续性部分或完全中断 ;股骨下端或胫骨上端骨质损伤 9例 ;关节积液 54例 ;多种损伤可同时出现。结论 :MR检查可很好显示膝关节损伤的各种表现 ,可作为膝关节损伤检查的重要或首选手段     

胫骨平台骨折及膝关节附属结构损伤的MRI诊断

目的评价胫骨平台骨折合并膝关节附属结构损伤的MRI表现.资料与方法 27例胫骨平台骨折病例经X线平片检查后作MRI扫描,分析不同类型胫骨平台骨折所合并的膝关节附属结构损伤的MRI形态学表现.结果 MRI能准确显示骨折所合并的膝关节附属结构的损伤性病变,包括关节软骨断裂、半月板撕裂和移位、侧副韧带和肌腱的撕裂、关节腔脂肪血性积液等,其中双髁骨折引起的损伤最为严重,撕脱骨折引起的损伤较轻.结论 MRI能准确诊断胫骨平台骨折合并的膝关节附属结构损伤,应作为膝关节外伤的常规检查手段.     

Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients

We examined 320 patients with MRI and arthroscopy after an acute trauma to evaluate MRI in diagnosis of degenerative joint disease of the knee in relation to sports activity and clinical data. Lesions of cartilage and menisci on MRI were registered by two radiologists in consensus without knowledge of arthroscopy. Arthroscopy demonstrated grade-1 to grade-4 lesions of cartilage on 729 of 1920 joint surfaces of 320 knees, and MRI diagnosed 14 % of grade-1, 32 % of grade-2, 94 % of grade-3, and 100 % of grade-4 lesions. Arthroscopy explored 1280 meniscal areas and showed degenerations in 10 %, tears in 11.4 %, and complex lesions in 9.2 %. Magnetic resonance imaging was in agreement with arthroscopy in 81 % showing more degenerations but less tears of menisci than arthroscopy. Using a global system for grading the total damage of the knee joint into none, mild, moderate, or severe changes, agreement between arthroscopy and MRI was found in 82 %. Magnetic resonance imaging and arthroscopy showed coherently that degree of degenerative joint changes was significantly correlated to patient age or previous knee trauma. Patients over 40 years had moderate to severe changes on MRI in 45 % and patients under 30 years in only 22 %. Knee joints with a history of trauma without complete structural or functional reconstitution showed marked changes on MRI in 57 %, whereas stable joints without such alterations had degenerative changes in only 26 %. There was no correlation of degenerative disease to gender, weight, type, frequency, and intensity of sports activity. Therefore, MRI is an effective non-invasive imaging method for exact localization and quantification of chronic joint changes of cartilage and menisci that recommends MRI for monitoring in sports medicine. Received: 28 July 1997; Revision received: 9 February 1998; Accepted: 20 March 1998     

MRI对膝关节盘状半月板及其损伤的诊断价值

目的:探讨MRI对膝关节盘状半月板及其损伤的诊断价值。方法:回顾性分析89例(151个膝关节)盘状半月板及其损伤的MRI、关节镜及手术资料。结果:89例盘状半月板中,88例(150个膝关节)为外侧盘状半月板,1例(1个膝关节)为内侧盘状半月板,表现为半月板增大、增宽、增厚,矢状面上可见≥3个层面前后角相连,冠状面髁间棘层面半月板宽度>15mm。本组中81例(138个膝关节)伴半月板损伤,发生率为91.40%,MRI表现为半月板不同程度变性或撕裂。与膝关节镜及手术对照,MRI图像对半月板损伤诊断的特异度为92.31%、敏感度为99.28%;对Ⅰ～Ⅱ级半月板损伤诊断的符合率为95.00%;对Ⅲ级半月板损伤诊断的符合率为98.98%。结论:MRI能准确判断盘状半月板类型及其损伤的范围和程度,是诊断盘状半月板及其损伤的最佳检查方法。     

Novel contrast mechanisms at 3 Tesla and 7 Tesla

Osteoarthritis (OA) is the most common musculoskeletal degenerative disease, affecting millions of people. Although OA has been considered primarily a cartilage disorder associated with focal cartilage degeneration, it is accompanied by well-known changes in subchondral and trabecular bone, including sclerosis and osteophyte formation. The exact cause of OA initiation and progression remains under debate, but OA typically first affects weightbearing joints such as the knee. Magnetic resonance imaging (MRI) has been recognized as a potential tool for quantitative assessment of cartilage abnormalities due to its excellent soft tissue contrast. Over the last two decades, several new MR biochemical imaging methods have been developed to characterize the disease process and possibly predict the progression of knee OA. These new MR biochemical methods play an important role not only for diagnosis of disease at an early stage, but also for their potential use in monitoring outcome of various drug therapies (success or failure). Recent advances in multicoil radiofrequency technology and high field systems (3 T and above) significantly improve the sensitivity and specificity of imaging studies for the diagnosis of musculoskeletal disorders. The current state-of-the-art MR imaging methods are briefly reviewed for the quantitative biochemical and functional imaging assessment of musculoskeletal systems.     

MR imaging of lipoma arborescens and the associated lesions

Objective To describe the typical features of lipoma arborescens on MR imaging with pathologic correlation and to evaluate the associated lesions within the joints.Design and patients The MR imaging findings of 32 patients with the diagnosis of lipoma arborescens of the knee (n=32) and shoulder (n=1) were reviewed. The diagnosis of lipoma arborescens was confirmed by the histologic findings in 12 cases and the other 21 cases were diagnosed by the characteristic MR imaging features. One patient had bilateral lipoma arborescens of the knee joint.Results MR imaging showed a typical pattern of villous lipomatous proliferation of the synovium in all cases, as a diffuse pattern in 79% (26/33) of cases and as a dominant mass-like lesion in 21% (7/33) of cases. The associated MR pathology in the knee was (n=32): joint effusion (100%), degenerative changes (87%), meniscal tear (72%), synovial cysts (38%), bone erosions (25%), chondromatosis (13%), patellar subluxation (6%) and discoid meniscus (3%). In all cases except two there was associated pathology of the knee. MR imaging showed an associated rotator cuff tear in the lipoma arborescens of the shoulder.Conclusion The characteristic MR features of lipoma arborescens allows an accurate diagnosis of this rare lesion, which is almost always associated with other chronic pathology of the joint in the elderly.     

膝关节半月板损伤的MRI诊断及临床分析

目的 分析MRI对膝关节半月板损伤诊断的价值.方法 对49例116个半月板损伤的MRI表现与关节镜或手术结果进行对照研究.结果 116个半月板中0级损伤11个,Ⅰ级损伤14个,Ⅱ级损伤50个,Ⅲ级损伤38个(Ⅲa级17个,Ⅲb级11个,Ⅲc级10个),Ⅳ级损伤3个.结论 MRI是膝关节半月板损伤的可靠检查方法.     

Spin-echo and 3D gradient-echo imaging of the knee joint: a clinical and histopathological comparison

Objective: A clinical and histopathological comparison of 2D spin-echo (SE) and 3D gradient-echo (3DGE) sequences was under-taken for the knee joint. The purpose of the study was to evaluate the clinical results and to explain the different appearances of meniscal abnormalities on both 2DSE and 3DGE images. Patients, materials and methods: The clinical study comprised 45 patients with arthroscopically correlated MR imaging results. For the histopathological correlation, seven cadaveric knee joints were examined with the same 2DSE and 3DGE (FISP) imaging protocol and sliced in sagittal sections according to the MR images. Different stainings were used. Results: For the detection of meniscal tears, accuracy (82.2%) and positive predictive value (70.7%) of the 3DGE sequence were limited due to a high number of false positive findings. Cartilaginous lesions were more easily visible on 3DGE than on 2DSE images (sensitivity: 63.1% vs. 52.6%, respectively). As in the clinical study, the meniscal signal abnormalities of the cadaveric knee joints were much more extensive on the 3DGE images than on the 2DSE images. The 3DGE findings correlated better with degenerative meniscal changes which were visible microscopically. Conclusion: The high sensitivity of the 3DGE sequence for degenerative meniscal changes explains the lack of specificity for the differentiation between meniscal degeneration and tears with this sequence. The MR grading system for meniscal lesions is of limited value for the evaluation of 3D FISP images.