膝关节盘状半月板分型与撕裂类型相关性的MRI分析

目的:进行盘状半月板的流行病学研究,探讨膝关节盘状半月板的诊断标准、分型及其与年龄、撕裂类型的关系,以提高对盘状半月板及撕裂MRI表现的认识。方法:对842例诊断为盘状半月板的患者按年龄分为≤19岁、20³9岁、4039岁、40⁵9岁、≥60岁组。对全部患者冠状面髁间棘层面半月板宽度与胫骨平台宽度之比(板面比)、矢状面"领结样"改变层面中半月板后角最厚层面的厚度及矢状面"领结样"改变层数进行测量、分析。根据盘状半月板MRI表现,分为板型、楔型、肥角型。分析盘状半月板分型、年龄与撕裂类型的关系。结果:盘状半月板以外侧多见,女性发病率是男性的1.64倍。842例中,板型535例、楔型274例、肥角型33例。半月板撕裂354例,撕裂率为42.0%。842例板/面比均≥0.20,矢状面"领结样"改变层面中半月板后角最厚层面的厚度≥4.40mm。盘状半月板分型与撕裂类型及年龄分布有关系,而年龄分布与撕裂类型无明显相关。结论:盘状半月板多见于外侧,常伴半月板撕裂。板面比≥0.20、矢状面"领结样"改变层面中半月板后角最厚层面的厚度≥4.40mm、矢状面连续≥3层"领结样"改变,为盘状半月板的MRI诊断标准;盘状半月板分型与撕裂类型有关系;年龄可影响盘状半月板分型。

MRI analysis of the correlation between classification of discoid menisci and tear type

Objective： To do the epidemiological study of the discoid meniscus,and to discuss the diagnostic criteria of discoid meniscus of the knee,and the relationship between classification and age, lesion, in order to improve the understanding of the MRI performance of discoid meniscus and lesion. Methods：842 cases diagnosed as discoid meniscus were divided into four groups as age≤19 years,20-39 years,40-59 years,andS60 years. Measure and analyze all cases＇ data of the ratio of the width of meniscus to that of tibial plateau on coronal slice,and the thickest thickness of the meniscus posterior horn on ＂butterfly＂ change layers on sagittal slice. The discoid menisci were divided into slab type, wedge type and hypertrophied-horn type. Analyse the relationship between classification and age of discoid meniscus and tear type. Results：Discoid meniscus was more common in the lateral. Female incidence of the discoid meniscus was 1.64 times that of male. There were 535 cases of slab type,274 cases of wedge type and 33 cases of hypertrophied-horn type,354 cases of meniscal tears,and the lesion rate was 42.0%. The ratio of the width of meniscus to that of tibial plateau≥0.20, the thickest thickness of the meniscus posterior horn on ＂butterfly＂ change layers≥4.40 mm. The discoid meniscus classification was related to tear type and the age distribution. The age distribution and tear type was not statistically related. Conclusion：Discoid meniscus is more common in the lateral, accompanied by meniscus lesion or tear usually. Three MRI diagnostic criteria for discoid meniscus is proposed as the ratio of the width of meniscus to that of tibial plateau≥0. 20, the thickest thickness of the meniscus posterior horn on ＂butterfly＂ change layers≥4.40 mm,and 3 or more than 3 consecutive layers discoid meniscus ＂butterfly＂ change. The discoid meniscus classification is related to tear type. The age distribution is related to discoid meniscus classification.