半月板和交叉韧带矢状断层研究

目的　观察膝关节矢状断层的半月板和交叉韧带的形态、可出现的层面情况并测量有关数据 ,为影像学诊断提供解剖学依据。方法　 11例 (2 2侧 )经福尔马林液防腐的膝关节标本按MRI检查姿势标线 ,冷冻后用断层带锯作厚 5mm的矢状断层 ,获得 314断层 (观察 5 84层面 ) ,对各断层面的半月板和交叉韧带进行观察 ,并用电子游标卡尺进行测量。结果　半月板后角高度明显高于前角 (P <0 0 1) ,内侧半月板后角宽度约是前角的 2倍 ,而外侧半月板宽度前、后角基本一致 ,外侧半月板体部宽于内侧且更靠近中轴 ,盘状半月板主要发生于外侧 ;正中矢状面显示交叉韧带全长的出现率为 82 % ,其全长的最好层面为正中矢状面和正中旁 1cm层面 ;前交叉韧带与矢状面的夹角较后交叉韧带小 ;前、后交叉韧带在股骨和胫骨的附着点宽约 12mm ,各附着点宽差异无显著性 (P >0 0 5 )。结论　膝关节矢状断层形态学研究提示半月板的后角容易损伤 ;外侧半月板后角明显较内侧窄而高 ,此为临床所见外侧半月板较内侧半月板更易损伤的形态学基础。

A study of meniscus and cruciate ligaments on sagittal section

Objective To provide anatomic basis for imaging diagnosis of the knee joint′s meniscus and cruciate ligaments on the sagittal section. Methods Eleven lower limbs were prepared anatomical subjects with formalin. According to the scanning position of MRI,these lower limbs were mark,frozen and sectioned. Every section was 5 mm in thickness. All 314 sections were obtained(observed 584 planes). Results The posterior horn of meniscus was distinctly higher than it′s anterior horn. The posterior horn of medical meniscus was nearly two times as wide as anterior horn. However,the wide of posterior horn and anterior horn in lateral meniscus showing no difference,the body of lateral meniscus was wide than of medical meniscus and much neared the middle. The discoid meniscus mainly took place on lateral meniscus. The rate of full long cruciate ligaments were observed in median saggital plane is 82 percent,the best plane to display the cruciate ligaments were median and paramedian saggital 1 st section. The angle between anterior cruciate ligament and saggital plane was smaller than posterior cruciate ligament. The width of attachment of anterior and posterior cruciate ligaments on the femur and tibia were 12 mm,there were no difference(P>0 05). Conclusion The saggital section of knee joint suggested that posterior horn of meniscus was easy to injure and posterior horn of lateral meniscus was much easy to injure than medial meniscus in the clinicaly. Above the characteristic about shape of knee joint is the morphology basis of imaging diagnosis of meniscus and cruciate ligament.