MRI hmanga khup meniscus leh ligament hliam hriat theih dan

Meniscus hi meniscus ang maia fibrocartilage a ni a, tibial condyle leh plateau inkarah triangular cross-section a awm a, hei hian femoro-tibial joint consistency nasa takin a ti tha a, knee joint dynamics-ah pawh hmun pawimawh tak a chang a ni.

MRI hmuhchhuah dan pangngai leh pangngai lo tak tak .

Sagittal leh frontal image-ah chuan meniscus pangngai chu hypointense-ah chuan triangular a ni. Lateral sagittal image-ah chuan meniscus chu 'bow-tie' structure a ni a, mid-sagittal section atanga siam niin anterior leh posterior horn te nen a inzawm a ni (Figure 1).

Figure 1 Medial meniscus-a MRI awm dan pangngai. Proton density-weighted sagittal view: A hma lam leh a hnunglam meniscal angle te hi homogeneous hypointense triangle an ni. Meniscus hi bow-shaped a ni a, a hma lama a hmalam ki leh a hnung lama a hnung lama ki inzawmte inzawmkhawmtu middle section section hrang hrang a awm a ni.

Anatomical abnormalities thenkhat chu meniscal split simulate thei a nih avangin hriatthiam a angkai hle:

• Sagittal section-ah chuan transverse leh anterior ligament inkar inthlak danglamna;

• popliteal tendon sheath hmanga siam a ni a;

• Humphrey leh Wrisberg-a ​​te meniscus-femoral ligament hian lateral meniscus hnunglam horn chu medial femoral condyle nen a thlunzawm a;

• Oblique meniscus ligament, a chang chuan meniscus hmalam horn chu a kalh zawnga meniscus hnunglam ki leh a hnung lam horn inzawm tirtu chuan migrating meniscus emaw barrel handle emaw a entawn thei a ni.

• Discoid meniscus hi congenital meniscus deformity hmuh tur awm lo tak a ni. He meniscal dysplasia hian lateral meniscus chauh a nghawng deuh ber. MRI-a a 'academic' diagnosis chu sagittal image-a anterior leh posterior horns continuity hmuh atanga 5 mm thick slices 3 a zawna 3 a zawna hmuh a ni (Fig. 2). Heng thil hmuhchhuah te hi partial settings hman dan a zirin siamrem a ni.

Figure 2 discoid lateral meniscus. Sagittal T1-weighted image a ni. 5mm fixed section 3 a zawna hma leh hnung lam corner chhunzawm zel. He discoid meniscus hmalam horn myxoid degeneration hi chhinchhiah rawh.

Meniscus pathology hmanga enfiah a ni.

Traumatic meniscus leh degenerative meniscus te hi a bul berah chuan thliar hran hi thil tih dan tlangpui a ni. Traumatic injuries hi mechanical force tam lutuk hmanga meniscus hrisel tak hman avanga lo awm a ni. Naupang puitlingah chuan fissure hi indirect valgus injury vang a ni tlangpui a, chu chu khup pawn lam a inher emaw hyperflexion emaw hnua tibia a san nghal a, flexion 20° a ni. Chu ai chuan, interstitial myxoid degeneration-in a tihchhiat meniscus-a mechanical force pangngai a thawh avanga degeneration a awm zawk a ni. Horizontal meniscal fissures hi a takin a lo awm thei a, a nih loh leh hliam tenau vang a ni thei bawk.

Classification hrang hrang .

Cleavage plane lam hawi chuan fissures te chu horizontal fissures, vertical fissures emaw complex fissures ah te then theih a ni.

Horizontal fissure a ni a.

Tibial plateau parallel-a split plane a awm a, chu chuan meniscus chu superior leh inferior segment-ah a then a ni. Heng horizontal lesions te hi a darh zau hle a, medial emaw lateral meniscus emaw chu nasa takin a nghawng thei a, stable anga ngaih a ni a, mahse medial meniscus tihchhiat hnua groove-a pem lut debris te chu sawi a ni tawh a ni.

Vertical fissure 1000 a ni.

Tibial plane-a perpendicular leh meniscus sir vel a perpendicular. Hengte hian medial meniscus a nghawng tlangpui zawk. Hliam tluantling chu unstable anga ngaih a ni a, meniscus chu medial leh lateral segment-ah a then a ni. Scanning level-ah hian lateral meniscus body leh meniscus posterior horn te pawh a tel a, hei hi barrel handle tear anga hriat sual a awlsam a, chu chu khup ruh chu pawn lam atanga a inher chuan a awm tam zawk a ni. Sagittal images nen a inzawm chuan barrel handle tear chu a chhuak thei (Figure 3).

A. coronal MRI, arrow chuan lateral meniscus hnunglam horn chu a kawhhmuh a, chu chu barrel handle crack anga hriat sual a awlsam a B. Figure-a dotted line-in a tarlan angin MRI scanning tih hian pseudo barrel handle tear a lo lang ang.

Radial fissures hi meniscus perimeter nen a inmil a, meniscus free edge a nghawng tlangpui.

parrot beak mittui tlak .

chu mixed vertical damage a ni a, longitudinal component leh radial component cyclically extending at the free edge a ni.

A tawp berah chuan meniscal injury complex tak tak a awm a, sawifiahna chiang tak awm lovin, horizontal leh vertical fissure tam tak a awm a ni.

Meniscus hliam vanga MRI a lan chhuah dan .

Meniscus mittui tlak .

Stoller leh a thawhpui te chuan an zir chiang a. Meniscus grade 3 rawt a ni (Figure 4) .

Grade 1: Meniscus leiah chuan hyperintensity nodular meniscus chu a awm reng a;

Grade 2: Signal linear meniscus sang tak chu meniscus chung lamah a awm reng a;

Grade 3: Hyperintensity hi meniscus articular surface pakhatah a inzar pharh a.

Figure 4 Stoller scale hi a ni. A: Grade 1: Meniscus-a articular surface nena inzawm, intermediate nodular hyperintensity site pakhat emaw a aia tam emaw; B: Grade 2: Meniscus-a articular surface-a linear intermediate hyperintensity; C: Grade 3: linear intermediate hyperintensity meniscus articular surface thlenga zau.

Grade 2 leh 3 inthliarna hi a tlem hle nachungin, degenerative intrameniscal hyperintensity (Figure 5) leh fissure dik tak a thliar hrang a ni. Hetianga degenerated leh torn meniscus thliar hranna hi a awlsam ngai lo va, extra emaw missing emaw a lo lan avangin tihsualna tam tak a awm bawk.

Figure 5. Meniscus-a a lan dan (degenerative appearance) chu. Sagittal proton density atanga thlir chuan thau saturation a awm. Signal sang area te chu fracture linear image dik tak awm lovin hmuh theih a ni.

Fimkhur tur: 1.1.

MRI hian performance tha tak a nei a, sensitivity leh specificity 90% leh 95% inkar a nei. MRI-ah chuan meniscal cleft chu intermediate linear hypointense extension angin a lang a, chu chu meniscus-a articular surface pakhat (Stoller grade 3), emaw, pure morphological abnormality emaw a ni.

Slice pakhata mittui hmuh theih chauh a nih chuan harsatna engemaw zat a awm a, a bik takin false positive result a awm theihna chance a sang hle. Linear meniscus chhunga hyperintensity hian meniscal surface a nghawng nasa hle a nih chuan, chu chu a kianga awm section pahnih tal a nih chuan pathological anga ngaih a tha. He concept hi image acquisition technique hman dan azirin siam danglam tur a ni (3 to 4 mm sections emaw isotropic mm section nei 3D volume hmuh theih a ni).

Radial meniscal clefts hi a chang chuan hriat a harsa zawk a, an orientation ngaihtuah chuan. Hengte hian a bulpui ber chu morphological abnormalities a thlen thin:

• frontal image-a free edge tihtawp emaw, amputation emaw;

• Sagittal image-a meniscus bowtie awm dan inzawm lo emaw, truncated emaw (Figure 6);

Figure 6. Sagittal proton density-weighted view-a medial meniscus hmalam segment-a radial fissure. Medial meniscus truncated bow tie (arrow) a awm dan pangngai.

• A bo emaw 'ghost' meniscus a awm a, a radial gap intact a awm bawk.

Meniscus rupture chu bucket handle hmanga rupture hian longitudinally extending spondylolisthesis 10% vel a ti buai a ni. Chutiang a nih chuan MRI sensitivity chu 70% vel a ni a, chu chu diagnostic criteria hman dan azirin a ni.

MRI atanga thil hmuhchhuah, ngaihven ngai:

A hmuh chhuah tam ber chu intercondylar region-a migrating fragments direct visualization a ni: 'double posterior cruciate ligament (PCL)' landmark hi medial meniscus a chhiat a, anterior cruciate ligament a awm chuan a characteristic a ni. Dislocated segment chu arcuate hypointense band angin a lang a, chu chu normal posterior cruciate ligament nen a inmil a, 'double PCL' hmel a siam chhuak a ni (Fig. 7). Rake horn tam lutuk (6 mm aia lian) hian barrel handle awmna a lantir thei bawk (Figure 8). Chutiang a nih chuan, a dislocated meniscus fragment chu healthy anterior horn-ah a innghat a ni.

Figure 7 Medial meniscus handle lan dan hian 'double PCL' tih ziak a nei a. Sagittal PD-weighted view with fat suppression: Meniscus fragment (arrow) a dislocated chu normal PCL (arrow) hnuaiah a awm a, a characteristic 'double cl' hmel a siam a.

Figure 8 Hma lam ki lian tak lan dan. Sagittal proton density atanga thlir chuan a rit hle. Dislocated fragment (arrow) hmalam lam chu anterior meniscus angle (arrow) ah an dah a. Hnung lam kilte chu a lang lo tih hre reng ang che (*).

MRI atanga thil hmuhchhuah dangte chu:

MRI sign dangte chu a dik tih finfiah a ni tawh a, chu chu bow tie awm lo, inverted meniscus sign, emaw meniscal fragments te chu millimeter frontal images (Fig. 9) emaw axial images-a intercondylar region-a direct-a displaced te an ni.

Figure 9 slot-a bucket handle hrual tawh. Fat suppression hnua frontal PD-weighted view. Acl (arrow) nen hian meniscus fragment (arrow) a awm a, chu chu a inzawm tlat a ni.

Meniscal instability chhinchhiahna formal tak chu menipheral displacement of meniscal fragments chu femoral meniscal recess emaw femoral-tibial recess emaw-ah hriatchhuah a ni. Heng displacement te hian medical meniscus chauh an huam a, 10% ah chuan horizontal cleft case thenkhat complication an ni. Coronal leh transverse section te hi heng fragment te hriat theihna kawng tha ber a ni.

Meniscus-a inhnimhnawihna chu a ni.

Meniscal detachment hi valgus hliam na tak avanga lo awm a ni a, meniscus’ capsular appendage a rupture vang a ni. Chungte chuan joint capsule thickening (the posterior oblique ligament) hmanga joint capsule-a innghat medial meniscus hnunglam horn chu a nghawng duh hle.

Anni chuan sagittal images-a tibial plate hnunglam border atanga meniscus sang zawk 5 mm offset an siam a (Fig. 11), emaw, meniscus base leh joint capsule plane inkarah fluid insertion an siam bawk.

Figure 11 Meniscus hnung lam horn-a detachment. Sagittal proton density atanga thlir theih a ni. Meniscus inthen tawh chu anterior-in an insawn chhuak a. Meniscus bul leh posterior capsule (arrow) inkarah hian hyperintensity (*) hmun zau tak a awm a.

Meniscus a floating a ni.

Hei hi tharum thawhnaa hliam tuar vang a ni a, meniscal-tibial ligament rupture leh meniscus medial portion detachment vang a ni. MRI-ah chuan meniscus inthen chu tuiin a hual vel vek a, tibial plateau-ah 'float' angin a lang (Figure 12).

Figure 12-a meniscus tui chunga leng. Frontal proton density view a thau saturation a awm bawk. Meniscus inthen chu tuiin a hual vel a, a bik takin a hnuai lam leh tibial plateau (arrow) inkarah a hual vel a ni.

Operation hnua Meniscus .

Meniscectomy hnua natna lo lang leh hian diagnostic harsatna tam tak a thlen a: recurrent fissures, postmeniscectomy, chondrolysis, subchondral necrosis, emaw arthralgia te. MRI hian recurrent fissures a hmuchhuak thei lo fo a, a chhan chu meniscectomy hian intermediate hyperintensities a hnutchhiah a, chu chuan 'dik tak' meniscus surface nen a inbiak thin a ni. Pathological anga ngaih leh recurrent fissure anga hrilhfiah a nihna hmuhchhuah awmchhun chu T2-weighted images-a fluid intrameniscal hyperintensity a ni. Heng simple MRI chauh tih theih lohna te hian ziaktu thenkhat chu MRI arthroscopy hman dan tur rawtna siam turin a fuih a, mahse hetah hian a result chu a inmil lo hle.

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