膝关节弓状韧带慢性损伤后的MRI表现

MRI of the Arcuate Ligament of Knee Joint Anatomical Imaging and Chronic Injury

摘要: 目的：探讨膝关节弓状韧带影像解剖特点及慢性损伤后的MRI表现。方法：回顾性总结分析10例正常膝关节弓状韧带影像解剖特点及30例膝关节弓状韧带慢性损伤患者的MRI表现。总结正常膝关节弓状韧带及其损伤后的形态、长度、宽度、走行及信号特点。结果：10例正常组及30例患者都具有弓状韧带。正常膝关节弓状韧带呈“Y”字形改变，位于膝关节股二头肌肌腱与腓肠肌外侧头之间的前方，自腓骨头起，走行与膝关节腘肌腱后方，并越过其后方呈“Y”字形向两端展开，融合于膝关节后外侧关节囊。膝关节弓状韧带分为外侧弓韧带、内侧弓韧带，MRI表现为各序列均为均匀低信号，边缘光滑，其内侧弓平均长(18.15 ± 1.36) mm，内侧弓平均宽(10.14 ± 1.22) mm；外侧弓平均长(24.86 ± 3.64) mm，外侧弓平均宽(13.26 ± 2.45) mm；膝关节弓状韧带损伤在压脂T2WI呈不均匀长T2信号，韧带纤维连续性差，纤维完全或部分肿胀，见条片状压脂高信号，部分韧带纤维完全断裂，周围合并出血，出现不均混杂信号。膝关节弓状韧带损伤后其内侧弓平均长(19.26 ± 2.58) mm，内侧弓平均宽(16.31 ± 3.57) mm；外侧弓平均长(23.74 ± 2.98) mm，外侧弓平均宽(20.15 ± 15.46) mm。结论：MRI扫描技术可清晰显示膝关节弓状韧带影像解剖及慢性损伤后的形态及结构特点，对于临床诊断及治疗具有一定指导意义。

Abstract: Objective: To investigate the anatomy of MRI features and the chronic injury of the knee joint after the arcuate ligament image. Methods: 10 cases of normal arcuate ligament of knee joint imaging anatomical MRI features and 30 cases of knee joint ligament, arcuate chronic injury patients were retrospectively analyzed. All subjects underwent high field MRI scan. The shape, length, width, course and signal characteristics of arcuate ligament of normal knee joint and those after injury were summarized. Results: 10 patients in the normal group and 30 patients had arcuate ligaments. Normal knee arcuate ligament showed the “Y” shape change, located in front of the knee between the biceps femoris tendon and the lateral head of the gastrocnemius muscle. The posterior line of the fibular head intersected with the knee tendon, which was in the shape of “Y” and extended to both ends, and the fusion was performed through the lateral articular capsule of the knee joint. The arcuate ligaments of the knee joint were divided into lateral arcuate ligaments and medial arcuate ligaments. MRI showed that all sequences showed uniform low signal and smooth edges. The mean length of the medial arch was (18.15 ± 1.36) mm, and the mean width of the medial arch was (10.14 ± 1.22) mm; the mean length of the lateral arch was (24.86 ± 3.64) mm, and the mean width was (13.26 ± 2.45) mm. Injure of arcuate ligament of knee showed uneven long T2 signals on T2WI, poor continuity of ligament fibers, complete or partial swelling of fibers, patchy hyperlipidemia signal, complete rupture of some ligament fibers, combined with surrounding bleeding, and unevenly mixed signals. After arcuate ligament injury, the median length of the medial arch was (19.26 ± 2.58) mm, and the median width was (16.31 ± 3.57) mm; the average length of the lateral arch was (23.74 ± 2.98) mm, and the average width was (20.15 ± 15.46) mm. Conclusion: MRI scanning technology can clearly display the imaging anatomy of arcuate ligament of knee joint and the morphology and structural characteristics after chronic injury, which has a certain guiding significance for clinical diagnosis and treatment.