Ale Si Nàzã MRI Atsɔ Akpɔ Klo ƒe Meniscus Kple Ligament ƒe Abixɔxɔ!

Meniscus nye fibrocartilage si le abe meniscus ene eye eƒe akpa etɔ̃ le eƒe akpa si le tibial condyle kple plateau dome, si nana femoro-tibial joint ƒe wɔwɔme nyona ɖe edzi ŋutɔ eye wòwɔa akpa vevi aɖe le klo ƒe ƒunukpeƒe ƒe dɔwɔwɔ me.

Normal Kple Nusiwo Mesɔ O Mri Nusiwo Wokpɔ

Le sagittal kple frontal nɔnɔmetatawo dzi la, meniscus si sɔ la nyea dzogoe etɔ̃ le hypointense me. Le sagittal nɔnɔmetata si le axadzi wu dzi la, meniscus nye 'bow-tie' xɔtuɖoɖo si me sagittal titina ƒe akpa aɖe si wotsɔ ƒo ƒu kple ŋgɔgbe kple megbe dzowo le (Nɔnɔmetata 1).

Nɔnɔmetata 1 MRI ƒe dzedzeme si sɔ le titina meniscus me. Proton density-weighted sagittal view: Meniscal ƒe dzogoe siwo le ŋgɔgbe kple megbe nye dzogoe etɔ̃ siwo ƒe ŋusẽ nye hypointense siwo sɔ. Meniscus la le abe dati ene eye titina ƒe akpa aɖewoe nye esiwo do ƒome kple eƒe ŋgɔgbedzo siwo le eŋgɔ kple eƒe megbedzo siwo le megbe nɛ.

Viɖe le eŋu be woase ŋutilã ƒe akpa aɖewo siwo mesɔ o gɔme elabena woate ŋu awɔ meniscal ƒe mama ƒe kpɔɖeŋu:

• Le sagittal section me la, tɔtrɔ si le transverse kple anterior ligaments dome;

• popliteal ƒe lãkusi ƒe akɔta;

• Humphrey kple Wrisberg ƒe meniscus-femoral ligament doa ka kple axadzi meniscus ƒe megbedzo kple medial femoral condyle;

• Meniscus ligament si le tsia dzi, si doa ka kple meniscus ƒe ŋgɔgbedzo kple megbeƒu si tsi tre ɖe eŋu ƒe megbeƒu ɣeaɖewoɣi la ate ŋu asrɔ̃ meniscus alo barrel ƒe asiléƒe si le ʋuʋum

• Discoid meniscus nye meniscus ƒe gbɔdzɔgbɔdzɔ si mebɔ o si wodzina. Meniscal dysplasia sia gblẽa nu le axadzi meniscus ɖeɖeko kloe ŋu. Eƒe 'academic' dɔlélewo didi le MRI dzi nɔ te ɖe ŋgɔgbe kple megbe dzowo ƒe yiyi dzi kpɔkpɔ le sagittal nɔnɔmetatawo dzi le 3 mm ya teti ƒe titrime ƒe kakɛ siwo kplɔ wo nɔewo ɖo me (Fig. 2). Wonɔa te ɖe ɖoɖo siwo wozã ƒe akpa aɖe dzi trɔa asi le nusiwo ŋu woke ɖo siawo ŋu.

Nɔnɔmetata 2 Discoid axadzi meniscus. Sagittal T1-dzidzenu ƒe nɔnɔmetata. Ŋgɔgbe kple megbe dzogoewo ƒe yiyi le 5mm ƒe akpa siwo woɖo ɖi 3 siwo kplɔ wo nɔewo ɖo dzi. De dzesi myxoid ƒe gbegblẽ le discoid meniscus sia ƒe ŋgɔgbe dzo ŋu.

Meniscus Dɔléle Ŋuti Nɔnɔmetatawo Xɔxɔ

Enye nuwɔna si bɔ be woade vovototo meniscus si gblẽa nu le ame ŋu kple meniscus si gblẽa nu dome koŋ. Abi siwo gblẽa nu le ame ŋu la tsoa mɔ̃ɖaŋununya ƒe ŋusẽ si gbɔ eme zazã ɖe meniscus si le lãmesẽ me ŋu. Le sɔhɛ tsitsiwo gome la, zi geɖe la, valgus ƒe abi si metso tẽ o, si nye afɔkpodzi ƒe kɔkɔ kpata le kloa ƒe gotagome tɔtrɔ alo eƒe ƒoƒo fũu akpa le 20° ƒe bɔbɔ megbe gbɔe ʋuʋudedia tsona. Ke boŋ, mɔ̃ŋusẽ siwo sɔ siwo wɔa dɔ ɖe meniscus si dome myxoid ƒe gbegblẽ gblẽ le la ƒe gbegblẽ dzɔna. Horizontal meniscal fissures ate ŋu adzɔ le eɖokui si alo abi suesuesuewo gbɔe wòtso.

Woƒe hatsotsowo me toto

Le cleavage plane ƒe mɔfiame nu la, woateŋu ama fissures ɖe horizontal fissures, vertical fissures alo complex fissures me

Horizontal Fissure si le tsia dzi

Yameʋu aɖe si me mã si sɔ kple tibial plateau si ma meniscus la ɖe akpa siwo le etame kple esiwo le ete me. Abi siawo siwo le tsia dzi la kaka, woate ŋu akpɔ ŋusẽ ɖe titina alo axadzi ƒe lãkusi dzi vevie, eye wobua wo be woli ke, togbɔ be woƒo nu tso gbeɖuɖɔ siwo ʋuna yia doa me le titina ƒe lãkusi ƒe gbegblẽ megbe hã.

Fissure si le Tsitrenu

Etsi tre ɖe tibial plane ŋu eye wòto meniscus ƒe gota gome. Esiawo gblẽa nu le medial meniscus ŋu wu. Wobua abi blibo be meli ke o eye wòmaa meniscus la ɖe titina kple axadzi ƒe akpawo me. Scanning level la lɔ axadzi meniscus ƒe ŋutilã kple meniscus ƒe megbe dzo hã ɖe eme, si woate ŋu akpɔ vodadatɔe bɔbɔe be enye barrel handle ƒe vuvu, si ate ŋu adzɔ wu ne klo ƒe ƒunukpeƒea trɔ ɖe gota. Ne wotsɔ sagittal nɔnɔmetatawo kpe ɖe eŋu la, woate ŋu agbe be ʋuƒo ƒe asiléƒe ƒe vuvu (Nɔnɔmetata 3).

A. Coronal MRI, aŋutrɔa fia asi megbedzo si le axadzi meniscus, si woate ŋu akpɔ vodadatɔe bɔbɔe be barrel handle crack; B. Ne wole MRI scan wɔm le teƒe si fli si le nɔnɔmetata la me ɖe fia nu la, pseudo barrel handle tear adze.

Radial fissures nɔa tsitre ɖe meniscus ƒe gotagome eye zi geɖe la, wokpɔa ŋusẽ ɖe meniscus ƒe go si le ablɔɖe me dzi.

Akpɔkplɔ ƒe Nuyi Aɖatsi

Enye nusiwo gblẽ le tsitrenu si wotsaka si me akpa si didi kple akpa si le dzogoe ene me si kekena ɖe enu le ablɔɖe nugbɔ le tsatsam.

Mlɔeba la, abi siwo sesẽ le ŋkume, siwo ŋu womeƒo nu tsoe nyuie o, siwo me ʋuʋudedi geɖe siwo le tsia dzi kple esiwo le tsitrenu le la li.

Mri Dzesiwo Le Meniscus ƒe Abixɔxɔ Ŋu

Meniscus ƒe Aɖatsi

Stoller kple exɔlɔ̃wo. do susua ɖa be woawɔ meniscus ƒe dzesi 3 (Nɔnɔmetata 4) .

Dzeside 1: Hyperintensity nodular meniscus si lé ɖe meniscus ƒe anyime;

Dzeside 2: Dzesi kɔkɔ linear meniscus si wolé ɖe meniscus ƒe anyime;

Dzeside 3: Ŋusẽ si gbɔ eme kekena ɖe enu va ɖoa meniscus ƒe ƒunukpeƒe ɖeka.

Nɔnɔmetata 4 Stoller ƒe dzidzenu. a: Dzeside 1: Nodular hyperintensity teƒe ɖeka alo esi wu nenema si do ƒome kple meniscus ƒe articular surface; b: Dzeside 2: Linear intermediate hyperintensity le meniscus ƒe ƒunukpeƒe; c: Dzeside 3: Linear intermediate hyperintensity keke ɖe enu va ɖo An articular surface of the meniscus.

Togbɔ be vovototo si le klass 2 kple 3 dome le sue hã la, edea vovototo degenerative intrameniscal hyperintensity (Nɔnɔmetata 5) kple fissures vavãtɔ dome. Vovototo sia si le meniscus si gblẽ kple esi vuvu dome la menɔa tẽ ɣesiaɣi o, eye vodadatsoƒe geɖewo li le esi wòdze abe ɖe wòsɔ gbɔ alo bu ene ta.

Figure 5. Meniscus ƒe dzedzeme si gblẽna. Sagittal proton density kpɔkpɔ kple ami ƒe agbɔsɔsɔ. Woate ŋu akpɔ dzesi kɔkɔwo ƒe teƒewo fracture linear image vavã aɖeke manɔmee.

Afɔɖeɖewo:

MRI ƒe dɔwɔwɔ nyo ŋutɔ, eye eƒe seselelãme kple eƒe tẽnyenye le 90% va ɖo 95% dome. Le MRI me la, meniscal cleft dzena abe domedome linear hypointense kekeɖenudɔwɔwɔ yi meniscus ƒe articular surfaces dometɔ ɖeka (Stoller grade 3), alo nɔnɔme si mesɔ o dzadzɛ ene.

Ne aɖatsia dzena le kakɛ ɖeka ko dzi la, kuxi aɖewo doa mo ɖa, vevietɔ afɔku gã si le alakpanu nyui siwo dona tso eme la me. Ne ŋusẽ si gbɔ eme le fli me meniscus me kpɔa ŋusẽ ɖe meniscal ƒe anyigba dzi vevie, si fia le akpa eve ya teti siwo te ɖe wo nɔewo ŋu me la, wokafui be woabui be enye dɔléle. Ele be woatrɔ asi le nukpɔsusu sia ŋu le nɔnɔmetata xɔxɔ ƒe mɔnu si wozã nu (3 va ɖo 4 mm ƒe akpawo alo 3D ƒe lolome xɔxɔ kple isotropic mm ƒe akpawo).

Ɣeaɖewoɣi la, esesẽna wu be woakpɔ radial meniscal clefts, ne wobu alesi wole ta. Esiawo koŋ hea nɔnɔme ƒe tɔtrɔ siwo mesɔ o vɛ:

• Nugbɔ ƒe nutsotso alo lãɖeɖe faa le ŋgɔgbe nɔnɔmetata la dzi;

• Meniscus bowtie ƒe dzedzeme si metso o alo esi wotso le sagittal nɔnɔmetata la dzi (Nɔnɔmetata 6);

Figure 6. Radial fissure le ŋgɔgbe akpa si le medial meniscus le sagittal proton density-weighted view me. Medial meniscus truncated bow tie (aŋutsrɔe) ƒe dzedzeme si sɔ.

• Meniscus si bu alo 'ghost' si si radial gap si me gblẽ o le.

Meniscus ƒe gbagbã kple bucket handle naa spondylolisthesis si kekena ɖe enu didi ƒe 10% lɔƒo sesẽna. Le go sia me la, MRI ƒe seselelãme anɔ abe 70% ene, le dɔlélewo didi ƒe dzidzenu siwo wozã nu.

Nusiwo ŋu woke ɖo le MRI me siwo ŋu wòle be woalé ŋku ɖo:

Nusi ŋu woke ɖo wue nye kakɛ siwo le ʋuʋum le lãkusiwo dome ƒe nuto me kpɔkpɔ tẽ: 'double posterior cruciate ligament (PCL)' ƒe dzesi nye dzesi ne medial meniscus gblẽ eye anterior cruciate ligament me gblẽ o. Akpa si woɖe ɖa la dzena abe arcuate hypointense band si sɔ kple megbe atitsoga ligament si sɔ, si wɔnɛ be 'double PCL' dzedzeme (Fig. 7). Rake-dzo siwo gbɔ eme (siwo ƒe lolome wu milimeta 6) hã ate ŋu aɖee afia be ʋuƒo ƒe asiléƒe le eŋu (Nɔnɔmetata 8). Le go sia me la, meniscus kakɛ si vuvu la léna ɖe ŋgɔgbedzo si le lãmesẽ me ŋu.

Figure 7 Dzesi si nye 'double PCL' le medial meniscus handle ƒe dzedzeme ŋu. Sagittal PD-weighted view with fat suppression: Meniscus kakɛ si woɖe ɖa (aŋutsrɔe) mlɔ PCL si sɔ (aŋutsrɔe) te eye wòwɔa 'double PCL' dzedzeme si ɖe dzesi.

Nɔnɔmetata 8 Kpẽ gã si le ŋgɔgbe la ƒe dzedzeme. Sagittal proton density ƒe kpekpeme ƒe nukpɔkpɔ. Wotsɔa kakɛ si ʋuʋu (aŋutsrɔe) ƒe ŋgɔgbekpa kpena ɖe ŋgɔgbe meniscus ƒe dzogoe (aŋutsrɔe) ŋu. De dzesii be womeɖe megbe dzogoeawo fia (*).

Nu bubu siwo ŋu woke ɖo le MRI me:

Woda asi ɖe MRI dzesi bubuwo dzi, abe bow tie si bu, meniscus ƒe dzesi si wogbugbɔ trɔ, alo meniscal kakɛ siwo woɖe yi intercondylar nutoa me tẽ le milimeta ŋgɔgbe nɔnɔmetatawo (Fig. 9) alo axial nɔnɔmetatawo dzi.

Figure 9 Bucket ƒe asiléƒe si woɖe le slot me. Frontal PD-weighted view le ami ƒe nutete megbe. Meniscus kakɛ si ʋuʋu (aŋutsrɔe) la le kadodo me kple ACL (aŋutsrɔe).

Dzesi bubu si woɖena fiana le se nu be meniscal meli ke o enye dzesidede meniscal kakɛ siwo le gota gome ƒe ʋuʋu yi afɔkpodzi ƒe meniscal recess alo femoral-tibial recess me. Ʋuʋu siawo lɔ atikewɔwɔ ƒe meniscus ɖeɖeko kloe ɖe eme eye wonye kuxi si dona tso horizontal cleft case aɖewo me le 10% me. Coronal kple transverse sections ye nye mɔ nyuitɔ si dzi woato ade dzesi kakɛ siawo.

Meniscus ƒe Dɔwɔha

Meniscal detachment dzɔna le valgus ƒe abi sesẽ ta eye meniscus ƒe capsular appendage ƒe gbagbã gbɔe wòtsona. Esiawo te ŋu kpɔa ŋusẽ ɖe megbedzo si le titina meniscus si léna ɖe ƒunukpeƒea ŋu to ƒunukpeƒe ƒe lãkusi (si nye megbeƒu si le tsia dzi) ƒe ƒoƒo me.

Wohea milimeta 5 ƒe vovototo yia meniscus si le etame gbɔ tso tibial plate ƒe megbe liƒo dzi le sagittal nɔnɔmetatawo dzi (Fig. 11), alo tsi dea meniscus ƒe gɔme kple ƒunukpeƒea ƒe yameʋu dome.

Nɔnɔmetata 11 Meniscus ƒe megbedzo ƒe ɖeɖeɖa. Sagittal proton ƒe kpekpeme ƒe nukpɔkpɔ. Woɖea meniscus si ma ɖe vovo la ɖa le ŋgɔgbe. Teƒe gã aɖe si ŋusẽ si gbɔ eme (*) le le meniscus ƒe gɔme kple megbeƒu ƒe lãkusi (aŋutsrɔe) dome.

Meniscus si le tsia dzi

Esia nye abixɔxɔ sesẽ aɖe me tsonu eye wòtso meniscal-tibial ligament ƒe gbagbã kple meniscus ƒe titina ƒe akpa si woɖe ɖa gbɔ. Le MRI me la, tsi ƒoa xlã meniscus si ma la keŋkeŋ eye wòdzena abe 'ele tsia dzi' le tibial plateau dzi ene (Nɔnɔmetata 12).

Nɔnɔmetata 12 Meniscus si le tsia dzi. Frontal proton density view kple ami ƒe agbɔsɔsɔ. Tsi ƒo xlã meniscus si ma la, vevietɔ le eƒe anyime kple tibial plateau (aŋutsrɔe) dome.

Dɔwɔwɔ vɔ megbe ƒe Meniscus

Vevesese enuenu le meniscectomy megbe hea kuxi geɖe vɛ le dɔlélewo didi me: ʋuʋudedi siwo gbugbɔna, meniscectomy megbe, chondrolysis, subchondral necrosis, alo arthralgia. Zi geɖe la, MRI mete ŋu dea dzesi ʋuʋudedi siwo gbugbɔna o elabena meniscectomy gblẽa domedome hyperintensities siwo 'masɔmasɔ' doa ka kple meniscus ƒe anyigba. Nu ɖeka kolia si ŋu woke ɖo si wobu be enye dɔléle eye woɖe egɔme be enye ʋuʋudedi si gbugbɔna dzɔnae nye tsi ƒe ŋusẽ si sɔ gbɔ wu le tsia me le nɔnɔmetata siwo woda T2 ƒe kpekpeme dzi. MRI bɔbɔe ɖeɖeko ƒe seɖoƒe siawo na agbalẽŋlɔla aɖewo do susua ɖa be woazã MRI ƒunukpeƒetetedɔ, togbɔ be le afisia hã la, emetsonuwo mewɔ ɖeka o hã.

Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?

Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si me ƒumeŋuɖui ƒe amekoko ƒe nusiwo wotsɔ dea ame me kple dɔwɔnu siwo sɔ kplii, nusiwo dometɔ aɖewoe nye akɔta ƒe akpa siwo wotsɔ dea ame me, ɖa siwo le lãkusi me, trauma plate, ʋuƒo si wotsɔ xea mɔ na nu, cranial-maxillofacial ƒe tagbɔ, ametia ƒe ŋutilã ƒe akpa aɖe, elektrikdɔwɔnuwo, gotagome fixators, ƒunukpeƒetetedɔ (arthroscopy)., lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe kpeɖeŋutɔ dɔwɔnuwo.

Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo wɔm eye míakeke adzɔnuwo ƒe hatsotsowo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho geɖe wu le xexeame katã ƒe ƒumeŋuɖui kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.

Míeɖoa nu ɖe ​​xexeame katã, eyata àte ŋui te ɖe mía ŋu le email adrɛs song@orthopedic-china.com hena nyayɔyɔ femaxee, alo ɖo gbedasi ɖe WhatsApp hena ŋuɖoɖo kaba +86- 18112515727 .

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