膝关节术后粘连MRI表现及临床特点

目的 观察膝关节术后关节粘连的MRI征象及其临床特点。方法 回顾性分析27例接受关节镜下膝关节手术后再次经关节镜证实存在膝关节粘连患者,观察其MRI表现及临床特点。结果 膝关节术后关节粘连MRI表现为膝关节腔内不同程度滑膜增厚,T1WI呈低信号,脂肪饱和(FS)质子密度(PD)WI呈中-高信号,其内可见多发条带状T2WI低信号,关节腔内无或仅见少量积液。关节镜及MRI示膝关节术后关节粘连可累及髌上囊(81.48%,22/27)、髌下脂肪垫(77.78%,21/27)、内外侧隐窝(51.85%,14/27)及髁间窝(22.22%,6/27);且多伴(23/27,85.19%)不同程度关节软骨损伤,常累及髌骨软骨及滑车软骨。结论 膝关节术后关节粘连多发生于术后中晚期,好发于髌上囊和髌下脂肪垫,多伴软骨损伤,特别是髌骨软骨和滑车软骨;其MRI特征性表现为不同程度滑膜增厚,FS PDWI呈中-高信号,内见多发条带状T2WI低信号,关节腔内无或仅见少量积液。

MRI manifestations and clinical characteristics of postoperative knee joint adhesion

Objective To observe the MRI manifestations and clinical characteristics of postoperative knee joint adhesion. Methods Data of 27 patients with knee joint adhesion confirmed by arthroscopy after arthroscopic knee surgery were retrospectively analyzed, and the MRI manifestations and clinical characteristics were observed. Results MRI manifestations of postoperative knee joint adhesion included different degrees of synovial thickening in joint cavity, with low signals on T1WI, medium and high signals on fat saturation (FS) proton density (PD) WI, and multiple striped low signals on T2WI in the thickened synovium, without or only with a small amount of effusion in joint cavity. Arthroscopy and MRI showed that the postoperative knee joint adhesion involved suprapatellar capsule (81.48%, 22/27), infrapatellar fat pad (77.78%, 21/27), medial and lateral recess (51.85%, 14/27) and intercondylar fossa (22.22%, 6/27). Different degrees of articular cartilage injury were found in 23 cases (23/27,85.19%), especially patellar cartilage and trochlear cartilage. Conclusion Postoperative knee joint adhesion occurred most in the middle and late stage after surgery, usually involved suprapatellar capsule and infrapatellar fat pad with cartilage injuries, especially patellar cartilage and trochlear cartilage. MRI manifestations were different degrees of synovial thickening, with medium and high signal on FS PDWI, and multiple striped low signals on T2WI could be seen in thickened synovium, without or only a small amount of effusion in joint cavity.