Otu esi eji MRI chọpụta Meniscus ikpere na mmerụ ahụ?

Meniscus bụ fibrocartilage nke yiri meniscus nke nwere akụkụ cross-triangular dị n'etiti condyle tibial na plateau, nke na-eme ka nkwonkwo femoro-tibial dịkwuo mma ma na-arụ ọrụ dị mkpa na nkwonkwo ikpere.

Nchọpụta Mri nkịtị na nke dị njọ

Na onyonyo sagittal na ihu, meniscus nkịtị bụ triangular na hypointense. N'elu onyonyo sagittal kachasị n'akụkụ, meniscus bụ ihe owuwu 'ụta-tie' nke nwere akụkụ etiti sagittal jikọtara ya na mpi ihu na azụ (ọgụgụ 1).

Ọgụgụ 1 Ọdịdị MRI nkịtị nke meniscus medial. Echiche sagittal njupụta nke proton: akụkụ ihu na azụ meniscal bụ triangles hypointense yiri. Meniscus dị ka ụta ma mejupụtara akụkụ nke akụkụ etiti nke jikọtara mpi ihu ya n'ihu ya na mpi azụ ya n'azụ ya.

Ọ bara uru ịghọta ụfọdụ ihe na-adịghị mma dịka ha nwere ike ime ka nkewa meniscal:

• Na ngalaba sagittal, mgbanwe n'etiti transverse na n'azụ ligaments;

• n'ọbọ akwara popliteal;

• Humphrey na Wrisberg's meniscus-femoral ligament jikọtara mpi azụ nke meniscus mpụta na condyle femoral medial;

• Njikọ meniscus oblique, nke na-ejikọta mpi ihu nke meniscus mgbe ụfọdụ na mpi azụ nke meniscus na-abụghị nke meniscus, nwere ike iṅomi meniscus na-akwaga ma ọ bụ aka gbọmgbọm.

• Discoid meniscus bụ nrụrụ meniscus na-adịghị ahụkebe. Nke a meniscal dysplasia na-emetụta ihe fọrọ nke nta ka ọ bụrụ nanị meniscus mpụta. Nchọpụta ya ' agụmakwụkwọ ' na MRI dabeere na ịhụ na-aga n'ihu nke mpi ihu na azụ na ihe oyiyi sagittal na ọ dịkarịa ala 3 na-esote 5 mm n'obosara (Fig 2). A na-edozi nchoputa ndị a dabere na ntọala akụkụ ejiri.

Ọgụgụ 2 Discoid mpụta meniscus. Onyonyo dị arọ nke Sagittal T1. Na-aga n'ihu n'ihu na nkuku azụ na akụkụ 3 na-esote 5mm na-edozi. Rịba ama nbibi myxoid nke mpi ihu nke meniscus discoid a.

Meniscus Pathology Imaging

Ọ bụ ihe a na-ahụkarị iji mata ọdịiche dị n'etiti meniscus traumatic na meniscus degenerative. mmerụ ahụ dị egwu na-esite n'itinye oke ike arụ ọrụ na meniscus dị mma. N'ime ndị na-eto eto, a na-ebutekarị fissure site na mmerụ ahụ valgus na-apụtaghị ìhè, elu mberede nke tibia mgbe ntụgharị mpụga ma ọ bụ hyperflexion nke ikpere na 20 ° nke mgbanwe. Kama nke ahụ, mmebi ahụ na-apụta n'ihi ike ọrụ nkịtị na-arụ ọrụ na meniscus mebiri site na mmebi interstitial myxoid. Ọkụkụ meniscal nke kwụ ọtọ nwere ike ịmalite ozugbo ma ọ bụ nwee ike bute ya site na obere mmerụ ahụ.

Nhazi

Dị ka ntụziaka nke ụgbọ elu mgbawa, enwere ike kewaa fissures gaa n'ihu n'ihu, ọkpụkpụ kwụ ọtọ ma ọ bụ mgbagwoju anya.

Ọkụkụ kwụ ọtọ

Enwere ụgbọ elu gbawara agbawa n'akụkụ ugwu tibial nke na-ekewa meniscus ka ọ bụrụ akụkụ dị elu na nke dị ala. Ọnya ndị a zuru oke, nwere ike imetụta meniscus medial ma ọ bụ n'akụkụ, a na-ewerekwa ya dị ka ihe kwụsiri ike, ọ bụ ezie na a kọwapụtara irighiri ihe ndị na-akwaga n'ime oghere mgbe e mebisịrị meniscus medial.

Fissure kwụ ọtọ

N'ikwekọ na ụgbọ elu tibia na gburugburu meniscus. Ndị a na-emetụtakarị meniscus medial. A na-ewere mmerụ ahụ zuru oke dị ka ihe na-adịghị akwụsi ike ma kewaa meniscus n'ime akụkụ nke etiti na n'akụkụ. Ọkwa nyocha ahụ na-agụnyekwa ahụ meniscus mpụta na mpi azụ nke meniscus, nke dị mfe ịchọpụta ya dị ka anya mmiri na-edozi gbọmgbọm, nke nwere ike ime mgbe nkwonkwo ikpere na-atụgharị n'èzí. Ejikọtara ya na onyonyo sagittal, enwere ike ịpụ adọka mmiri aka barrel (Njirimara 3).

A. Coronal MRI, akụ na-atụ aka na mpi azụ nke meniscus n'akụkụ, nke dị mfe na-aghọtahie dị ka gbọmgbọm aka mgbawa; B. Mgbe ị na-eme nyocha MRI dị ka ọnọdụ egosiri n'ahịrị nwere ntụpọ dị na ọnụ ọgụgụ a, adọka mmiri nke pseudo barrel ga-apụta.

Ọkpụkpụ radial na-adakarị na mpụta nke meniscus ma na-emetụtakarị ọnụ ọnụ meniscus n'efu.

Parrot Beak akwa

Bụ mmebi kwụ ọtọ agwakọtara nke nwere akụrụngwa ogologo yana akụkụ radial na-agbatị cyclically na nsọtụ efu.

N'ikpeazụ, enwere mmerụ ahụ meniscal dị mgbagwoju anya, na-enweghị nkọwa doro anya, gụnyere ọtụtụ mgbawa kwụ ọtọ na kwụ ọtọ.

Ngosipụta Mri nke Meniscus mmerụ ahụ

Meniscus akwa

Stoller et al. Atụụrụ akara 3 nke meniscus (Fig 4)

Ọkwa 1: Hyperintensity nodular meniscus echekwabara n'elu meniscus;

Ọkwa 2: Meniscus akara akara dị elu ka edobere n'elu meniscus;

Ọkwa 3: Ọbara ọbara na-agbatị n'otu elu elu nke meniscus.

Onyonyo 4 Ọnụ ọgụgụ nke ihe nchekwa. a: Ọkwa 1: Otu ma ọ bụ karịa n'etiti nodular hyperintensity saịtị jikọtara na articular elu nke meniscus; b: Ọkwa 2: hyperintensity etiti etiti Linear na elu articular nke meniscus; c: Ọkwa 3: Ọbara ọbara dị n'etiti ahịrị na-agbatị ruo n'elu oghere nke meniscus.

Ọ bụ ezie na ọdịiche dị n'etiti klaasị 2 na 3 dị obere, ọ na-amata oke hyperintensity intrameniscal degenerative (Njirimara 5) na ezi fissures. Ọdịiche a dị n'etiti meniscus mebiri emebi na nke dọwara adọwa anaghị adị mfe mgbe niile, yana enwere ọtụtụ ebe njehie n'ihi ọdịdị nke mgbakwunye ma ọ bụ na-efu.

Ọgụgụ 5. Ọdịdị mmebi nke meniscus. Echiche njupụta proton sagittal nwere saturation abụba. Enwere ike ịhụ mpaghara mgbama dị elu na-enweghị ezigbo onyonyo ahịrị mgbaji.

Mkpachapụ anya:

MRI nwere arụmọrụ dị mma, yana nghọta na nkọwa dị n'etiti 90% na 95%. Na MRI, mgbawa nke meniscal na-egosi dị ka mgbatị hypointense nke etiti na-aga n'ihu na otu n'ime elu elu nke meniscus (Stoller grade 3), ma ọ bụ ihe na-adịghị mma morphological.

Mgbe a na-ahụ anya mmiri naanị n'otu iberi, enwere ụfọdụ ihe isi ike, karịsịa nnukwu ihe ize ndụ nke nsonaazụ ụgha. Ọ bụrụ na hyperintensity n'ime linear meniscus na-emetụta nke ukwuu n'elu meniscal, ya bụ na ọ dịkarịa ala abụọ n'akụkụ akụkụ, a na-atụ aro na-atụle pathological. Ekwesịrị ịmegharị echiche a dabere na usoro nnweta onyonyo ejiri (akụkụ 3 ruo 4 mm ma ọ bụ nweta olu 3D nwere akụkụ isotropic mm).

Ọkpụkpụ radial meniscal na-esikwa ike mgbe ụfọdụ ịchọpụta, n'ihi usoro ha na-aga. Ndị a na-ebutekarị n'ọdịdị morphological:

• Nkwụsị ihu ma ọ bụ bepụ n'efu na onyonyo ihu;

• Akwụsị ma ọ bụ mkpụbelata ọdịdị nke meniscus bowtie na foto sagittal (Nyocha 6);

Onyonyo 6. Ihe nhụsianya radial na akụkụ ihu nke meniscus medial na sagittal proton njupụta-elele. Ọdịmma nke etiti meniscus gbajiri ụta ụta (akụ).

• Meniscus na-efu ma ọ bụ 'ghost' nwere oghere radial na-adịghị.

Njiji nke meniscus jiri aka ịwụ na-agbagwoju anya ihe dịka 10% nke spondylolisthesis na-agbatị ogologo oge. N'okwu a, mmetụta uche nke MRI bụ ihe dịka 70%, dabere na njirisi nyocha ejiri.

Nchọpụta MRI chọrọ nlebara anya:

Ihe nchoputa a na-ahụkarị bu nleba anya nke mpempe akwụkwọ na-akwaga na mpaghara intercondylar: akara ngosi ' double posterior cruciate ligament (PCL)' bụ ihe e ji mara mgbe meniscus meniscus mebiri emebi na ligament nke ihu adịghị adị. Akụkụ a gbapụrụ agbapụ na-egosi dị ka eriri hypointense arcuate nke kwekọrọ na ligament azụ azụ azụ, na-emepụta ọdịdị 'PCL ugboro abụọ' (Fig 7). Mpi dị oke egwu (ihe karịrị 6 mm n'ogo) nwekwara ike igosipụta ọnụnọ nke ogwe aka gbọmgbọm (Foto 8). N'okwu a, a na-ejikọta iberi meniscus nke gbapụrụ agbapụ na mpi ihu dị mma.

Ọgụgụ 7 Ọdịdị nke meniscus medial nwere akara 'PCL ugboro abụọ'. Echiche dị arọ nke Sagittal PD nwere mbelata abụba: Iberibe meniscus (akụ) ahụ ewepụsịrị dị n'okpuru PCL nkịtị (akụ) wee mepụta njirimara 'ugboro abụọ PCL' ọdịdị.

Ọgụgụ 8 Ọdịdị nke nnukwu mpi n'ihu. Ngosipụta njupụta nke Sagittal proton nlele. A na-ejikọta akụkụ dị n'ihu nke iberibe iberibe (akụ) n'akụkụ ihu meniscus (akụ). Rịba ama na egosighi nkuku azụ (*).

Nchọpụta MRI ndị ọzọ:

A kwadoro akara ngosi MRI ndị ọzọ, dị ka ụta ụta na-efu efu, akara meniscus tụgharịrị, ma ọ bụ iberibe meniscal chụpụrụ ozugbo na mpaghara intercondylar na ihe oyiyi ihu millimeter (Fig 9) ma ọ bụ ihe oyiyi axial.

Ọgụgụ 9 Aka ịwụ agbapụrụ n'ime oghere. Nlele PD dị n'ihu ma emechie abụba. Iberibe meniscus (akụ) a chụpụrụ agbasa na kọntaktị na ACL (akụ).

Ihe ịrịba ama ọzọ a na-ahụ anya nke enweghị ntụkwasị obi nke meniscal bụ njirimara nke mwepu nke mpụta nke mwepu n'ime oge ezumike femoral meniscal ma ọ bụ ezumike femoral-tibial. Nchụpụ ndị a na-agụnye ihe fọrọ nke nta ka ọ bụrụ naanị meniscus ahụike ma bụrụ ihe mgbagwoju anya nke ụfọdụ ọgbaghara na 10% nke ikpe. Akụkụ coronal na transverse bụ ụzọ kacha mma isi mata iberibe ndị a.

Meniscus Detachment

Mwepu nke meniscal na-apụta n'ihi mmerụ ahụ siri ike nke valgus ma na-ebute ya site na mgbawa nke ngwa capsular meniscus. Ndị a na-emetụtakarị mpi azụ nke meniscus medial nke na-ejikọta na capsule nkwonkwo site na ịgbatị capsule nkwonkwo (njikọ oblique nke azụ).

Ha na-ebute nkwụsị nke 5 mm na meniscus dị elu site na njedebe azụ nke efere tibial na ihe oyiyi sagittal (Fig 11), ma ọ bụ ntinye mmiri n'etiti isi nke meniscus na ụgbọelu nke capsule nkwonkwo.

Ọgụgụ 11 Mwepu nke mpi azụ nke meniscus. Echiche njupụta proton sagittal. Meniscus kewara ekewa na-apụ n'ihu. Enwere nnukwu ebe hyperintensity (*) n'etiti isi nke meniscus na capsule azụ (akụ).

Meniscus na-ese n'elu mmiri

Nke a bụ n'ihi mmerụ ahụ na-eme ihe ike ma bụrụ n'ihi nkwụsị nke meniscal-tibial ligament na nkwụsị nke akụkụ etiti nke meniscus. Na MRI, mmiri mmiri gbara gburugburu meniscus nke kewapụrụ kpamkpam wee yie ka ọ na-ese n'elu tibial plateau (Foto 12).

Ọgụgụ 12 meniscus na-ese n'elu mmiri. Echiche njupụta proton n'ihu yana saturation abụba. Mmiri gbara ya gburugburu meniscus kewara ekewa, ọkachasị n'etiti elu ya dị ala na ala ala tibial (akụ).

Meniscus postoperative

Mgbu na-aga n'ihu mgbe meniscectomy gasịrị na-enye ọtụtụ ihe isi ike nchọpụta: mgbawa ugboro ugboro, postmeniscectomy, chondrolysis, subchondral necrosis, ma ọ bụ arthralgia. MRI anaghị achọpụtakarị fissures ugboro ugboro n'ihi na meniscectomy na-ahapụ hyperintensities etiti nke 'na-ezighi ezi' na-ekwurịta okwu na elu meniscus. Naanị ihe nchoputa nke a na-ewere na ọ bụ ọrịa na-akọwapụta ya dị ka mgbawa na-emegharị ugboro ugboro bụ hyperintensity intrameniscal nke mmiri na ihe oyiyi T2. Mbelata ndị a nke MRI dị mfe naanị emewo ka ụfọdụ ndị na-ede akwụkwọ na-atụ aro ka e jiri MRI arthroscopy eme ihe, ọ bụ ezie na ọzọ nsonaazụ ebe a enweghị nkwekọrịta.

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