目的 探讨半月板下表面撕裂(meniscus lower surtace tear,MLST)的MRI影像学表现及与半月板撕裂传统分型的差异。方法 以“桶柄状撕裂”“水平撕裂”“复杂撕裂”为关键词,检索2018-06至2021-06在医院影像归档系统(picture archiving and communication systems,PACS)中膝关节MRI病例,以“下表面缺损、上表面完整,且移位半月板碎片与下表面缺损形态、大小相匹配”为标准,共纳入28例资料进行研究,观察其MRI直接征象(撕裂特征、部位、碎片移位方向)及间接征象。结果 半月板下表面缺损28例,上表面完整24例;水平合并纵行撕裂28例;撕裂发生于半月板体部12例,体部合并后角7例;撕裂局限在半月板“红区” 4例,累及“白区” 24例;半月板碎片后角移位19例,髁间窝移位14例;领结残破征18例;后角异常肥大征15例;半月板翻转征9例;熔岩流动征8例;碎片内移征6例;外周残半月板征6例;双前角征5例;双后交叉韧带征4例;空领结征3例。结论 MLST具有特征性的MRI表现,将MLST与半月板撕裂传统分型区分开来具有重要的临床意义。
Abstract
Objective To investigate the MRI manifestations of meniscus lower surface tear (MLST) and the differences from those of meniscus tears classified by traditional methods. Methods Using “bucket-handle tear”, “horizontal tear” and “complex tear” as keywords, cases involving MRI of knees in the hospital picture archiving and communication system (PACS) were retrieved from June 2018 to June 2021. A total of 28 patients were included in the study based on the criteria of “defects on the lower surface, integrity on the upper surface, and displaced meniscus fragments that match the shape and size of the defects on the lower surface”. Direct signs of MRI (tear features, locations and directions of displacement) and indirect signs were observed. Results Twenty-eight cases had lower surface defects of the meniscus, 24 cases had upper surface integrity, 28 cases had horizontal combined with longitudinal tears, 12 cases had tears in the body of the meniscus and 7 cases had tears in the body combined with the posterior horn, 4 cases had tears confined to the “red zone” of the meniscus and 24 cases had tears in the “white zone”. Nineteen cases had posterior horn displacement of meniscus fragments, 14 cases had intercondylar fossa displacement, 18 cases had broken bow tie signs, 15 cases had posterior horn abnormal hypertrophy signs, 9 cases had flipped meniscus signs, 8 cases had lava flow signs, 6 cases had internal displaced fragments signs, 6 cases had abnormal circumferential meniscus signs, 5 cases had double anterior horn signs, 4 cases had double posterior cruciate signs and 3 cases had empty bow tie signs. Conclusion MLST have characteristic MRI manifestations, and it is of great significance to distinguish MLSTs from traditionally-classified meniscal tears.
关键词
磁共振成像 /
半月板 /
下表面 /
撕裂
Key words
magnetic resonance imaging /
meniscus /
lower surface /
tear
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