膝关节侧副韧带损伤MRI影像诊断的比较研究

目的研究膝关节侧副韧带损伤的MRI诊断与法医学鉴定意义。方法对经手术或临床证实的11例共13条损伤的侧副韧带与12例正常膝关节进行回顾性MRI对比研究。结果正常胫、腓侧副韧带在T1WI和T2WI上均呈扁平条状低信号结构,平均长度分别为6.8cm和5.7cm;13条侧副韧带损伤,单纯胫侧副韧带损伤6条,单纯腓侧副韧带损伤3条,两侧侧副韧带同时损伤2例4条;其中I级侧副韧带损伤5条,II级侧副韧带损伤5条;III级侧副韧带损伤3条;7例(63.6%)出现并发症,其中前交叉韧带损伤3条,后交叉韧带损伤4条,半月板损伤2个。结论MRI能清晰显示膝关节侧副韧带解剖结构,能准确诊断侧副韧带损伤并进行分级,还能发现多种并发症,对法医学鉴定有重要意义。

The compare disquisition of the collateral ligaments: normal and pathologic appearances on MRI

Objective To evaluate the MR findings of normal and abnormal collateral ligament and the meaning of medical jurisprudence appraisal.Methods The MR findings of12normal and13surgically confirmed injured collateral ligaments were retrospectively reviewed and compared.Results The normal tibial and fibular collateral ligaments were hypointense string on both T 1 and T 2 coronal MR images,with average length of6.8cm for tibial collateral ligament and5.7cm for fibular collateral ligament.13collateral ligaments were injured,including6tibial and3fibular collateral ligaments.Two cases(4ligaments)had both tibial and fibularcollateral ligaments injuries.The injury of collateral ligament was classified as:Grade I(5ligaments),Grade II(5ligaments),and Grade III(3ligaments).The complications of anterior cruci - ate ligament sprains(3cases),posterior cruciate ligament sprains(4cases),meniscal tear(2cases)were found in7patients(63.6%).Conclusion Coronal MR imaging can clearly demonstrate the structure of the knee collateral ligaments,accurately diagnose and classify the ligament injury,and correctly detect the compli - cations,MRI is very valuable for medical jurisprudence appraisal.