膝关节军事训练性骨挫伤的MRI表现及临床意义

【目的】初步探讨膝关节军事训练性骨挫伤的MRI影像学表现及其临床意义。【方法】对87例X线或CT检查结果为阴性的军事训练性膝关节损伤患者进行MRI检查。根据骨挫伤的分布及其损伤机制，将81例确诊为膝关节骨挫伤的患者分为轴移型损伤、仪表盘型损伤、过伸型损伤、夹击型损伤及髌骨外侧脱位等五型。【结果】骨挫伤的MRI表现为片状地图样异常信号影，边界不清。PDWI上表现为低信号、T2WI上表现为高信号；在PDWI或T2WI脂肪抑制序列上表现为高信号。81例MRI确诊为骨挫伤的患者中轴移性损伤32例，仪表盘式损伤18例，过伸型损伤11例，夹击式损伤13例，髌骨外侧脱位7例。【结论】MRI能够准确显示膝关节军事训练性骨挫伤的部位、范围及其附属结构的损伤。通过对骨挫伤进行分类，可以推断其损伤机制，并且能够为推测其附属结构损伤提供线索。

The MRI appearance and clinical significance of military training related bone contusion of the knee joint

Objective] To investigate the MRI appearance and clinical significance of military training related bone contu-sion of the knee joint. Methods] MRI examination was performed in 87 cases of acute knee joint injury resulting from military training, whose X-ray and/or CT results were negative. According to the distribution of bone contusion and in-jury mechanism, 81 cases of the total 87 patients who were diagnosed as bone contusion were classified into five types as pivot shift injury, clip injury, dashboard injury, hyperextension injury and lateral pate] lar dislocation. Results] Bone contusion were identified at MR imaging as geographic areas of poorly marginated abnormal signal intensity, that is, de-creased signal intensity with PD-weighted sequence, increased signal intensity with T2-weighted sequences, and increased signal intensity in PD-weighted or T2-weighted images with fat saturation. Among the 81 patients who were diagnosed by bone contusion, including 32 cases of pivot shift injury, 18 cases of dashboard injury, 11 cases of hyperextension injury, 13 cases of clip injury and 7 cases of lateral patellar dislocation. Conclusions] MRI can easily display the distribution of the military training related bone contusion of the knee joint as well as it's adjunctive structure injury. The mechanism of injury can be determined by studying the distribution of bone contusion, which then enables one to predict with accuracy the specific soft-tissue abnormalities.