Sɛnea Wɔde MRI Di Dwuma De Hu Kotodwe Meniscus ne Ligament Opira!

Meniscus yɛ fibrocartilage a ɛte sɛ meniscus a ne fã a ɛyɛ ahinanan a ɛwɔ tibial condyle ne plateau ntam, na ɛma femoro-tibial nkwaa no yɛ pɛpɛɛpɛ kɛse na edi dwuma titiriw wɔ kotodwe nkwaa mu nkɔso mu.

Normal Ne Abnormal Mri Nhwehwɛmu

Wɔ sagittal ne frontal mfonini ahorow so no, meniscus a ɛteɛ no yɛ ahinanan wɔ hypointense mu. Wɔ sagittal mfonini a ɛwɔ akyi sen biara no so no, meniscus no yɛ 'bow-tie' nhyehyɛe a ɛyɛ mfinimfini sagittal fã bi a wɔde anim ne akyi mmɛn no aka ho (Mfonini 1).

Mfonini 1 MRI a ɛda adi sɛnea ɛte daa a ɛwɔ mfinimfini meniscus no mu. Proton density-weighted sagittal view: Anim ne akyi meniscal ahinanan no yɛ hypointense ahinanan a ɛyɛ pɛ. Meniscus no te sɛ agyan na ɛyɛ mfinimfini fã no afã horow a ɛka n’anim mmɛn a ɛwɔ n’anim ne n’akyi mmɛn a ɛwɔ n’akyi no bom.

Mfaso wɔ so sɛ yɛbɛte nipadua mu nneɛma bi a ɛnteɛ ase efisɛ ebetumi ayɛ meniscal mpaapaemu ho mfonini:

• Wɔ sagittal section mu no, nsakrae a ɛba transverse ne anterior ligaments ntam;

• popliteal ntini a wɔde hyɛ nipadua no mu;

• Humphrey ne Wrisberg meniscus-femoral ligament no de akyi abɛn a ɛwɔ akyi meniscus no bata medial femoral condyle no ho;

• Meniscus ligament a ɛyɛ oblique a ɛtɔ mmere bi a ɛka meniscus no anim abɛn ne meniscus a ɛne no bɔ abira no akyi abɛn no bom no betumi asuasua meniscus anaa toa nsa a ɛkɔ baabi foforo

• Discoid meniscus yɛ awosu mu dɛmdi a ɛntaa nsi. Ɛkame ayɛ sɛ saa meniscal dysplasia yi ka lateral meniscus no nkutoo. Ne 'adesua' nhwehwɛmu a wɔyɛ wɔ MRI so no gyina sɛnea wohu sɛnea anim ne akyi mmɛn no kɔ so wɔ sagittal mfonini ahorow so wɔ anyɛ yiye koraa no 3 a ɛtoatoa so a ne kɛse yɛ mm 5 mu (Mfonini 2). Wɔgyina nhyehyɛe ahorow a wɔde di dwuma no fã bi so na ɛyɛ nsakrae wɔ nea wɔahu yi mu.

Mfonini 2 Discoid akyi meniscus. Sagittal T1-kari mfonini. Ntoaso a ɛwɔ anim ne akyi ntwea so wɔ 3 a ɛtoatoa so 5mm fixed sections. Hyɛ myxoid asɛe a ɛwɔ saa discoid meniscus yi anim abɛn no nsow.

Meniscus Yare Ho Mfoniniyɛ

Ɛyɛ adeyɛ a abu so sɛ wobehu nsonsonoe titiriw a ɛda meniscus a ɛyɛ hu ne meniscus a ɛyɛ mmerɛw ntam. Apirakuru a ɛyɛ hu fi mfiri ahoɔden a ɛboro so a wɔde di dwuma wɔ meniscus a ɛte apɔw so. Wɔ mmerante ne mmabaa a wɔadu mpanyin afe so mu no, mpɛn pii no, mpaapaemu no fi valgus opira a ɛnteɛ, tibia a ɛkɔ soro mpofirim bere a wɔadan akɔ akyi anaasɛ wɔabɔ kotodwe no boro so wɔ 20° a wɔabɔ no akyi. Mmom no, ɔsɛe ba esiane mfiri tumi a ɛfata a ɛyɛ adwuma wɔ meniscus a myxoid a ɛsɛe wɔ ntam asɛe no so nti. Horizontal meniscal fissures betumi ayɛ nea ɛba ara kwa anaasɛ ebetumi afi opira nketenkete mu aba.

Nkyekyɛmu a wɔkyekyɛ mu

Sɛnea cleavage plane no kwankyerɛ kyerɛ no, wobetumi akyekyɛ mpaapaemu no mu ayɛ no mpaapaemu a ɛda fam, mpaapaemu a ɛda fam anaasɛ mpaapaemu a ɛyɛ den

Horizontal Fissure a Ɛwɔ Hɔ

Plane bi a apaapae a ɛne tibial plateau no di nsɛ a ɛkyekyɛ meniscus no mu yɛ no afã horow a ɛwɔ soro ne nea ɛwɔ fam no wɔ hɔ. Saa akuru a ɛkɔ soro yi trɛw, ebetumi aka mfinimfini anaa akyi meniscus no kɛse, na wobu no sɛ ɛyɛ den, ɛwom sɛ wɔaka nneɛma a asɛe a ɛkɔ groove no mu bere a asɛe medial meniscus no ho asɛm de.

Vertical Fissure a Ɛwɔ Hɔ

Ɛyɛ tẽẽ wɔ tibial plane no ho na ɛfa meniscus no ho hyia. Eyinom taa ka medial meniscus no kɛse. Wobu opira a edi mũ sɛ entumi nnyina na ɛkyekyɛ meniscus no mu yɛ no mfinimfini ne akyi afã horow. Scanning level no nso ka akyi meniscus nipadua ne meniscus no akyi abɛn a ɛnyɛ den sɛ wobehu no yiye sɛ toa nsa tetetew, a ɛda adi kɛse sɛ ɛba bere a wɔadan kotodwe nkwaa no akɔ akyi no. Sɛ wɔde sagittal mfonini ahorow ka ho a, wobetumi apow sɛ toa nsa tetew (Mfonini 3).

A. Coronal MRI, agyan no kyerɛ akyi abɛn a ɛwɔ akyi meniscus no, a ɛnyɛ den sɛ wobehu no wɔ ɔkwan a ɛnteɛ so sɛ toa nsa mu mpaapaemu; B. Sɛ wɔreyɛ MRI scanning sɛnea gyinabea a nsensanee a ɛwɔ mfonini no mu no kyerɛ no a, pseudo barrel handle tear bɛda adi.

Radial fissures no gyina hɔ ma meniscus no ho na ɛtaa ka meniscus no ano a ɛyɛ ahofadi no.

Parrot Anom Nusu

Ɛyɛ afrafra vertical damage a ɛyɛ longitudinal fã ne radial fã cyclically trɛw wɔ free edge.

Awiei koraa no, meniscal opira a ɛyɛ den wɔ hɔ, a wɔankyerɛkyerɛ mu pefee biara, a ɛfa mpaapaemu pii a ɛkɔ soro ne nea ɛda fam ho.

Mri Nneɛma a Ɛda Meniscus Opira Ho

Meniscus Nsuo a Ɛwɔ Hɔ

Stoller ne afoforo. de nyansahyɛ mae sɛ wɔmfa meniscus nni dwuma 3 (Mfonini 4) .

Grade 1: Hyperintensity nodular meniscus a ɛkora so wɔ meniscus no ani;

Grade 2: Nsɛnkyerɛnne a ɛkorɔn linear meniscus a wɔakora so wɔ meniscus no ani;

Grade 3: Hyperitensity trɛw kɔ meniscus no articular surface biako so.

Mfonini 4 Stoller nsenia. a: Grade 1: Mfinimfini nodular hyperintensity beae biako anaa nea ɛboro saa a ɛne meniscus no articular surface wɔ abusuabɔ; b: Grade 2: Linear mfinimfini hyperintensity wɔ articular surface a ɛwɔ meniscus no so; c: Grade 3: Linear intermediate hyperintensity a ɛtrɛw kɔ An articular surface of the meniscus.

Ɛwom sɛ nsonsonoe a ɛda adesuakuw 2 ne 3 ntam no sua de, nanso ɛma nsonsonoe da degenerative intrameniscal hyperintensity (Mfonini 5) ne mpaapaemu ankasa ntam. Ɛnyɛ bere nyinaa na nsonsonoe a ɛda meniscus a asɛe ne nea atetew ntam yi yɛ tẽẽ, na mfomso pii wɔ hɔ esiane sɛ ɛte sɛ nea ɛboro so anaasɛ ɛyera nti.

Mfonini 5. Sɛnea meniscus no te sɛ nea ɛyɛ mmerɛw. Sagittal proton density hwɛ ne srade a ɛyɛ den. Wobetumi ahu mmeae a nsɛnkyerɛnne a ɛkorɔn a wonni nokware fracture linear image biara.

Ahwɛyiye a ɛsɛ sɛ yɛyɛ:

MRI wɔ adwumayɛ a ɛkyɛn so, a nkate ne pɔteeyɛ wɔ 90% ne 95% ntam. Wɔ MRI so no, meniscal cleft da adi sɛ mfinimfini linear hypointense ntrɛwmu kɔ meniscus no articular surfaces no biako so (Stoller grade 3), anaasɛ morphological abnormality kronkron.

Sɛ wotumi hu nusu no wɔ slice biako pɛ so a, nsɛnnennen bi wɔ hɔ, titiriw asiane kɛse a ɛwɔ hɔ sɛ atoro a ɛyɛ papa befi mu aba no. Sɛ hyperintensity a ɛwɔ linear meniscus no mu no ka meniscal no ani kɛse, kyerɛ sɛ anyɛ yiye koraa no wɔ afã abien a ɛbɛn ho a, wɔkamfo kyerɛ sɛ wobu no sɛ ɛyɛ ɔyare. Ɛsɛ sɛ wɔsesa saa adwene yi gyina mfonini a wɔfa so nya kwan a wɔde di dwuma no so (3 kosi 4 mm afã horow anaasɛ wobenya 3D volume a isotropic mm afã horow wom).

Ɛtɔ mmere bi a, ɛyɛ den sɛ wobehu radial meniscal clefts, esiane sɛnea ɛkɔ so nti. Eyinom titiriw na ɛde nipadua mu nneɛma a ɛnyɛ ne kwan so ba:

• Free edge interruption anaa amputation wɔ anim mfonini no so;

• Meniscus bowtie a ɛda adi wɔ sagittal mfonini no so a ɛnkɔ so anaasɛ wɔatwa no (Mfonini 6);

Mfonini 6. Radial fissure wɔ anim fã a ɛwɔ medial meniscus no mu wɔ sagittal proton density-weighted view mu. Mfinimfini meniscus a wɔatwa no bow tie (agyan) no sɛnea ɛte daa.

• Meniscus a ayera anaa 'ghost' a ɛwɔ radial gap a enni dɛm.

Sɛ wɔde bokiti nsa paapae meniscus no mu a, ɛma bɛyɛ 10% yɛ den wɔ spondylolisthesis a ɛtrɛw kɔ akyiri no mu. Wɔ saa tebea yi mu no, MRI no nkate bɛyɛ 70%, a egyina nhwehwɛmu a wɔde di dwuma no so.

Nneɛma a wɔahu wɔ MRI mu a ɛsɛ sɛ wɔhwɛ so:

Nea wɔtaa hu ne asinasin a ɛretu wɔ intercondylar mpɔtam hɔ a wohu tẽẽ: 'double posterior cruciate ligament (PCL)' agyiraehyɛde no yɛ su bere a medial meniscus no asɛe na anterior cruciate ligament no nni dɛm. Ɔfã a atutu no da adi sɛ arcuate hypointense band a ɛne akyi cruciate ligament a ɛteɛ no di nsɛ, na ɛma 'double PCL' hwɛbea (Mfonini 7). Rake mmɛn a ɛboro so (a ne kɛse boro mm 6) nso betumi akyerɛ sɛ toa nsa wɔ hɔ (Mfonini 8). Wɔ eyi mu no, meniscus asinasin a atutu no bata anim abɛn a ɛte apɔw no ho.

Mfonini 7 Sɛnea medial meniscus nsa no te no wɔ 'double PCL' sɛnkyerɛnne. Sagittal PD-weighted view with fat suppression: Meniscus asinasin a atutu (agyan) no da PCL a ɛteɛ no ase (agyan) na ɛyɛ 'double PCL' a ɛda adi no.

Mfonini 8 Sɛnea anim abɛn kɛse no te. Sagittal proton density a wɔkari hwɛ. Asinasin a abubu no anim fã (agyan) no bata anim meniscus anim (agyan) no ho. Hyɛ no nsow sɛ wɔankyerɛ akyi ntwea so (*).

Nneɛma afoforo a wɔahu wɔ MRI mu:

Wɔagye MRI nsɛnkyerɛnne afoforo atom, te sɛ bow tie a ayera, meniscus sɛnkyerɛnne a wɔadan no, anaasɛ meniscal asinasin a wɔatu akɔ intercondylar mpɔtam hɔ tẽẽ wɔ milimita anim mfonini ahorow (Mfonini 9) anaa axial mfonini ahorow so.

Mfonini 9 Bokiti nsa a atutu wɔ slot mu. Anim PD-weighted view akyi srade a wɔasiw ano. Meniscus asinasin a atutu (agyan) no ne ACL (agyan) no di nkitaho.

Nsɛnkyerɛnne foforo a ɛwɔ ɔkwan a ɛfata so a ɛkyerɛ sɛ meniscal no ntumi nnyina pintinn ne sɛ wobehu sɛ meniscal asinasin a ɛwɔ akyi no tu kɔ asen no mu ntini no mu anaasɛ asen no mu ntini a ɛwɔ akyi no mu. Ɛkame ayɛ sɛ saa atutra yi fa aduruyɛ mu meniscus no nkutoo ho na ɛyɛ ɔhaw a ɛba wɔ nsɛm bi a ɛfa mpaapaemu a ɛkɔ soro ho wɔ nsɛm no mu 10% mu. Coronal ne transverse sections ne ɔkwan a eye sen biara a wɔfa so hu saa asinasin yi.

Meniscus a Wɔde Tew Nnipa Ho

Meniscal detachment ba esiane valgus opira a emu yɛ den nti na efi meniscus no capsular appendage a ɛpaapae mu. Eyinom taa ka medial meniscus no akyi abɛn a ɛbata nkwaa no mu ntini no ho denam nkwaa no mu ntini a ɛyɛ den (akyi ntini a ɛyɛ oblique ligament) no so.

Wɔde mm 5 a ɛtwetwe kɔ meniscus a ɛwɔ soro no so fi tibial mprɛte no akyi hye so wɔ sagittal mfonini ahorow so (Mfonini 11), anaasɛ nsu a wɔde hyɛ meniscus no ase ne nkwaa capsule no plane ntam.

Mfonini 11 Meniscus no akyi abɛn no a ɛpaapae. Sagittal proton density hwɛbea. Meniscus a wɔatew mu no tu kɔ anim. Beae kɛse bi a hyperintensity (*) wɔ meniscus no ase ne akyi capsule (agyan) no ntam.

Meniscus a ɛsensɛn nsu so

Eyi fi opira a ano yɛ den mu na efi meniscal-tibial ligament a ɛpaapae ne meniscus no mfinimfini fã a ɛpae. Wɔ MRI so no, nsu atwa meniscus a wɔatew mu no ho ahyia koraa na ɛte sɛ nea 'ɛsen' wɔ tibial plateau no so (Mfonini 12).

Mfonini 12 Meniscus a ɛsensɛn nsu so. Anim proton density hwɛ ne srade saturation. Nsu atwa meniscus a wɔatew ho no ho ahyia, titiriw wɔ ne fam a ɛwɔ fam ne tibial plateau (agyan) no ntam.

Oprehyɛn akyi Meniscus

Ɛyaw a ɛsan ba bere a wɔatwa meniscectomy akyi no de nsɛnnennen pii ba wɔ sɛnea wobehu mu: mpaapaemu a ɛsan ba, meniscectomy akyi, chondrolysis, subchondral necrosis, anaa arthralgia. MRI taa ntumi nhu mpaapaemu a ɛsan ba efisɛ meniscectomy gyaw mfinimfini hyperintensities a 'mfomso' ne meniscus no ani di nkitaho. Ade biako pɛ a wohui a wobuu no sɛ ɛyɛ ɔyare na wɔkyerɛɛ ase sɛ mpaapaemu a ɛsan ba ne nsu a ɛwɔ meniscal hyperintensity wɔ mfonini ahorow a wɔde T2 akari mu no so. Saa anohyeto ahorow yi a ɛwɔ MRI a ɛnyɛ den nkutoo mu no ama akyerɛwfo binom ahyɛ nyansa sɛ wɔmfa MRI ntini mu nhwehwɛmu nni dwuma, ɛwom sɛ bio nea afi mu aba wɔ ha no nhyia de.

Sɛnea Wɔtɔ Nnompe a Wɔde Si Nnompe Mu ne Nnompe Ho Nnwinnade!

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Bio nso, yɛasi yɛn bo sɛ yɛbɛkɔ so ayɛ nneɛma foforo na yɛatrɛw nneɛma ahorow mu, sɛnea ɛbɛyɛ a yebedi nnuruyɛfo ne ayarefo pii oprehyɛn ahiade ho dwuma, na yɛama yɛn adwumakuw no nso asi akan kɛse wɔ wiase nyinaa nnompe a wɔde hyɛ nipadua mu ne nnwinnade adwuma no nyinaa mu.

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