膝关节半月板及韧带损伤的MRI表现,河北医科大学第三医院 孙英彩,www.themegallery.com,半月板损伤 Injury of The Menisci,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,半月板损伤MRI分为三级 级损伤即早期退变或变性 级损伤即严重变性，是级损伤的继续 级损伤即撕裂（Menisci Tear）斜行撕裂、水平撕裂、垂直撕裂、放射状撕裂、纵形撕裂、桶柄状撕裂（Bucket-handleTear）、复杂撕裂、半月板关节囊分离,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,盘状半月板（Discoid Meniscus） MRI-sag: 5mm层厚扫描时有3个或以上层面显示半月板前后角相连，形成蝴蝶结样改变 Cor-半月板最窄处宽度大于14-15mm，外侧缘高于对侧2mm以上,www.themegallery.com,www.themegallery.com,www.themegallery.com,交叉韧带正常ACL起于髁间嵴前区,向上后外至于股骨外髁内后面PCL起于髁间后区,向上前内,至于股骨内髁外后面,www.themegallery.com,交叉韧带损伤(Injury of The Cruciate Ligaments) 交叉韧带损伤MRI表现 前交叉韧带损伤有完全撕裂和部分撕裂 MRI上区分部分和完全撕裂困难 前交叉韧带完全撕裂直接征象为 ACL连续性中断 韧带扭曲呈波浪状 ACL内形成假瘤，在T1WI呈低信号，T2WI上呈高信号，并且见不到完整的纤维束 T2WI上ACL内呈现弥漫性高信号,www.themegallery.com,后交叉韧带断裂的征象 PCL连续性中断，残余的韧带退缩、扭曲 MRI上未显示PCL 在T1WI、T2WI上呈不规则的高信号 PCL胫骨附着点有撕脱的骨碎片和后交叉韧带相连而韧带的连续性未见中断,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,侧副韧带损伤 Injury of The Collateral Ligaments,正常解剖 胫侧副韧带起自股骨内侧收肌结节之下，止于胫骨的内侧，相当于胫骨粗隆水平，长度约11cm，宽度约1.5cm 腓侧副韧带起自股骨外上髁上方，止于腓骨头下方，呈一个圆索条状结构，长约5-7cm,www.themegallery.com,侧副韧带损伤 Injury of The Collateral Ligaments,影像学表现 MRI上正常副韧带在任何序列均为低信号 检查多采用冠状面和横轴面检查,www.themegallery.com,侧副韧带损伤 Injury of The Collateral Ligaments,影像学表现 侧副韧带损伤MRI上表现为韧带内长T2高信号 完全断裂表现为韧带连续性中断或韧带增粗、肿胀、韧带内弥漫性高信号,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,www.themegallery.com,髌韧带损伤 Injury of The Patellar Ligaments,正常解剖 为股四头肌的延续部 是全身最强大的韧带之一 位于膝关节囊的正前方 起自髌尖及其后方的粗面，向下止于胫骨粗隆，长约8cm,www.themegallery.com,髌韧带损伤 Injury of The Patellar Ligaments,影像学表现 MRI上任何序列均表现为低信号 矢状面和横轴面显示好 部分撕裂时MRI上表现为韧带内高信号 完全撕裂时表现为韧带断裂，髌骨上移，韧带呈波浪状改变,www.themegallery.com,www.themegallery.com,www.themegallery.com,髌韧带损伤 Injury of The Patellar Ligaments,www.themegallery.com,www.themegallery.com,股四头肌腱,www.themegallery.com,www.themegallery.com,病例,www.themegallery.com,病例,www.themegallery.com,www.themegallery.com,www.themegallery.com,谢谢,