Ndlela yo tirhisa MRI ku kambela ku vaviseka ka matsolo ya meniscus na ligament, .

Meniscus i fibrocartilage ya xivumbeko xa meniscus leyingana triangular cross-section leyi kumekaka exikarhi ka tibial condyle na plateau, leswi antswisaka swinene femoro-tibial joint consistency naswona yi tlanga xiave xa nkoka eka matsolo ya mahlangano.

Swikumiwa swa MRI leswi tolovelekeke ni leswi nga tolovelekangiki .

Eka swifaniso swa sagittal na frontal, meniscus leyi tolovelekeke yiva na triangular eka hypointense. Eka xifaniso xa sagittal xa le tlhelo swinene, meniscus i xivumbeko xa 'bow-tie' lexi vumbiwaka hi xiphemu xa le xikarhi ka sagittal lexi hlanganisiweke na timhondzo ta le mahlweni na ta le ndzhaku (Xifaniso 1).

Xifaniso 1 Ku humelela ka MRI ya ntolovelo ya meniscus ya le xikarhi. Proton density-weighted sagittal view: Ti angle ta le mahlweni na ta le ndzhaku ta meniscal i ti triangles ta hypointense leti fanaka. Meniscus yina xivumbeko xa vurha naswona yina swiphemu swa xiphemu xale xikarhi leswi hlanganisaka timhondzo ta yona tale mahlweni emahlweni ka yona na timhondzo ta yona tale ndzhaku endzhaku ka yona.

Swi pfuna ku twisisa ku nga tolovelekangi ko karhi ka anatomical tani hi leswi swi nga tekelelaka ku avana ka meniscal:

• Eka xiyenge xa ​​sagittal, ku cinca exikarhi ka ti transverse na anterior ligaments;

• Xifunengeto xa Nsinya wa Nsinya wa Popliteal;

• Humphrey na Wrisberg’s Meniscus-femoral ligament yi hlanganisa rimhondzo ra le ndzhaku ra meniscus ya le tlhelo na condyle ya le xikarhi ya femoral;

• Xirhendzevutana xa meniscus lexi oblique, lexi minkarhi yin’wana xi hlanganisaka rimhondzo ra le mahlweni ra meniscus ni rimhondzo ra le ndzhaku ra meniscus leri hambaneke, ri nga ha tekelela meniscus kumbe barrel handle .

• Discoid meniscus i ku onhaka ka meniscus loku nga tolovelekangiki ka ku velekiwa. Dysplasia leyi ya meniscal yi khumba kwalomu ka meniscus ya le tlhelo ntsena. Ku kamberiwa ka yona ka 'academic' eka MRI ku sekeriwe eka ku vona ku ya emahlweni ka timhondzo ta le mahlweni na ta le ndzhaku eka swifaniso swa sagittal eka kwalomu ka 3 wa swilayi swo tika swa 5 mm hi ku landzelelana (Fig. 2). Swikumiwa leswi swi lulamisiwa hi ku ya hi swiyimiso swa xiphemu leswi tirhisiweke.

Xifaniso 2 Discoid lateral meniscus. Xifaniso xa Sagittal T1-weighted. Ku ya emahlweni ka tikhoneni ta le mahlweni na ta le ndzhaku eka swiphemu swa 3 swa 5mm leswi nga cinciki leswi landzelelanaka. Xiya ku onhaka ka myxoid ka rimhondzo ra le mahlweni ra meniscus leyi ya discoid.

Meniscus Pathology Swifaniso .

I mukhuva lowu tolovelekeke ku hambanisa hi xisekelo exikarhi ka meniscus leyi chavisaka na degenerative meniscus. Ku vaviseka loku chavisaka ku vangiwa hi ku tirhisiwa ka matimba yo tlula mpimo ya michini eka meniscus leyi hanyeke kahle. Eka vantshwa lavakulu, fissure hi ntolovelo yivangiwa hiku vaviseka ka valgus lokunga kongomangiki, ku tlakuka ka xitshuketa ka tibia endzhaku ka ku rhendzeleka ka le handle kumbe hyperflexion ya matsolo eka 20° ya flexion. Ematshan’wini ya sweswo, ku onhaka ku humelela tani hi mbuyelo wa matimba ya ntolovelo ya michini lawa ya tirhaka eka meniscus lawa ya onhiweke hi interstitial myxoid degeneration. Ti horizontal meniscal fissures tinga humelela hiku tisungulela kutani tinga vangiwa hiku vaviseka kutsongo.

Ku hlawuriwa ka swiyenge .

Hi ku ya hi tlhelo ra xiphemu xa cleavage, swiphemu-phemu swi nga avanyisiwa hi swiphemu leswi nga etlhelo, ku avana loku yimisiweke kumbe ku avana loku rharhanganeke .

Xirhendzevutana xa horizontal .

Kuna split plane leyi fambelanaka na tibial plateau leyi avanyisa meniscus hi swiphemu swale henhla na swale hansi. Swirhumbana leswi swa horizontal swihangalakile, swinga khumba swinene medial kumbe lateral meniscus, naswona swi tekiwa swiri leswi tiyeke, hambi leswi thyaka leri rhurhelaka eka groove endzhaku ka ku onhaka ka meniscus yale xikarhi ri hlamuseriwile.

Xirhendzevutana lexi yimisiweke .

perpendicular eka tibial plane nale kusuhi na circumference ya meniscus. Leswi swi tala ku khumba ngopfu meniscus ya le xikarhi. Ku vaviseka loku heleleke ku tekiwa ku nga tshamisekanga naswona ku avanyisa meniscus hi swiphemu swa le xikarhi na swa le tlhelo. Level ya scanning yitlhela yi katsa miri wa lateral meniscus xikan’we na posterior horn ya meniscus, leswi swi olovaka ku swikuma kahle tani hi barrel handle tear, leswi swinga tala ku humelela loko matsolo ya hlangana ehandle. Loko swi hlanganisiwa na swifaniso swa sagittal, ku hlongoriwa ka barrel handle ku nga ha hlongoriwa (Xifaniso 3).

A. Coronal MRI, nseve wu kombetela eka rimhondzo ra le ndzhaku ra meniscus ya le tlhelo, leswi olovaka ku kamberiwa hi ndlela yo biha tanihi leswi barrel yi khomaka ku pandzeka; B. Loko u endla ku skena ka MRI hi ku ya hi xiyimo lexi kombisiweke hi layini ya mathonsi eka xifaniso, ku ta humelela mihloti ya pseudo barrel handle.

Ti radial fissures ti perpendicular eka perimeter ya meniscus naswona hi ntolovelo ti khumba free edge ya meniscus.

Parrot Beak Tear .

i ku onhaka loku pfanganisiweke ka vertical loku vumbiwaka hi xiphemu xa longitudinal na xiphemu xa radial lexi hangalakaka hi ku rhendzeleka eka tlhelo ra mahala.

Eku heteleleni, ku na ku vaviseka loku rharhanganeke ka meniscal, handle ka nhlamuselo leyi nga erivaleni, leyi katsaka ku pandzeka ko tala ka horizontal na vertical.

Swikombiso swa MRI swa ku vaviseka ka meniscus .

Meniscus Ku handzuka .

Stoller na van’wana. Xiringanyeto xa 3 wa tigiredi ta Meniscus (Xifaniso 4) .

Giredi ya 1: Hyperintensity Nodular Meniscus yi hlayisiwile ehenhla ka vuandlalo bya meniscus;

Giredi ya 2: Xigingi xa le henhla xa linear meniscus xi hlayisiwile ehenhla ka vuandlalo bya meniscus;

Giredi ya 3: hyperintensity yi anama kuya eka articular surface yin’we ya meniscus.

Xifaniso xa 4 Xikalo xa Stoller. A: Giredi ya 1: Ndhawu yin’we kumbe ku tlula ya le xikarhi ya nodular hyperintensity leyi fambelanaka na articular surface ya meniscus; B: giredi ya 2: linear intermediate hyperintensity eka articular surface ya meniscus; C: Giredi ya 3: Linear intermediate hyperintensity leyi hangalakaka ku ya eka articular surface ya meniscus.

Hambi leswi ku hambana exikarhi ka tigiredi ta 2 na 3 ku nga ku ringanela, ku hambanyisa degenerative intrameniscal hyperintensity (Xifaniso 5) eka ti fissures ta ntiyiso. Ku hambana loku exikarhi ka meniscus leyi onhakeke na leyi handzukeke a hi minkarhi hinkwayo yi kongomeke, naswona ku na swihlovo swo tala swa xihoxo hikwalaho ka ku humelela ka leswi engetelekeke kumbe leswi kayivelaka.

Xifaniso 5. Xivumbeko xa degenerative xa meniscus. Sagittal proton density view na fat saturation. Tindzhawu ta swikombiso swale henhla tinga voniwa handle ka xifaniso xa ntiyiso xa fracture linear.

Switsundzuxo:

MRI yina matirhelo ya kahle swinene, na sensitivity na specificity exikarhi ka 90% na 95%. Eka MRI, ku pandzeka ka meniscal ku humelela tanihi ku engeteriwa ka linear hypointense ya le xikarhi eka yin’wana ya swiphemu swa articular swa meniscus (Stoller Grade 3), kumbe ku nga tolovelekangi ka xivumbeko xo basa.

Loko ku handzuka ku vonaka ntsena eka xiphemu xin’we, ku va ni swiphiqo swo karhi, ngopfu-ngopfu khombo lerikulu ra vuyelo lebyinene bya mavunwa. Loko hyperintensity endzeni ka linear meniscus yi khumba swinene vuandlalo bya meniscal, i.e. eka swiphemu swimbirhi leswi nga ekusuhi, switsundzuxiwa kuva swi tekiwa tani hi pathological. Mhaka leyi yifanele ku cinciwa kuya hi thekiniki ya ku kuma swifaniso leyi tirhisiweke (3 kuya eka 4 mm swiphemu kumbe ku kuma 3D volume leyingana swiphemu swa isotropic MM).

Ti radial meniscal clefts minkarhi yin’wana swa tika swinene ku ti kambela, loko ku langutiwa ku kongoma ka tona. Leswi ngopfu-ngopfu swi yisa eka ku nga tolovelekangi ka xivumbeko:

• ku kavanyetiwa ka free edge kumbe ku tsemiwa ka swirho eka xifaniso xa le mahlweni;

• Xivumbeko lexi nga fambisaniki kumbe lexi tsemiweke xa Meniscus Bowtie eka xifaniso xa sagittal (Xifaniso 6);

Xifaniso 6. Radial fissure eka xiphemu xa le mahlweni xa meniscus ya le xikarhi eka xivono xa sagittal proton density-weighted. Ku languteka loku tolovelekeke ka meniscus ya le xikarhi ya meniscus truncated bow tie (nseve).

• A missing kumbe 'Ghost' meniscus leyi nga na xivandla xa radial lexi nga onhakiki.

Ku phatluka ka meniscus hi xikhomela xa bakiti swi rharhanganisa kwalomu ka 10% wa longitudinally extending spondylolisthesis. Eka xiyimo lexi, ku twisisa ka MRI i kwalomu ka 70%, kuya hi swipimelo swa vukamberi leswi tirhisiweke.

Swikumiwa swa MRI leswi lavaka nyingiso:

Ku kumiwa loku tolovelekeke ngopfu i ku vonakala ko kongoma ka swiphemu leswi rhurhelaka eka ndhawu ya intercondylar: 'double posterior cruciate ligament (PCL)' landmark i xihlawulekisi loko meniscus ya le xikarhi yi onhakile naswona anterior cruciate ligament yi nga onhakanga. Xiphemu xa dislocated xi humelela tani hi arcuate hypointense band leyi fambelanaka na ligament ya ntolovelo ya cruciate ya le ndzhaku, yi humesa xivumbeko xa 'double Pcl' (Fig. 7). Timhondzo ta rake leti tlulaka mpimo (ku tlula 6 mm hi vukulu) tinga tlhela ti kombisa vukona bya xikhomela xa barrel (Xifaniso xa 8). Eka xiyimo lexi, xiphemu xa meniscus lexi tshovekeke xi khomanisiwile na rimhondzo ra le mahlweni leri hanyeke kahle.

Xifaniso 7 Ku humelela ka xikhomela xa meniscus xa le xikarhi xi na xikombiso xa 'double pcl'. Sagittal PD-weighted view with fat suppression: Xiphemu xa meniscus lexi tshovekeke (nseve) xi le hansi ka PCL ya ntolovelo (nseve) naswona xi vumba xivumbeko xa 'double pcl' xivumbeko.

Xifaniso xa 8 Ku humelela ka rimhondzo ra le mahlweni lerikulu. Sagittal proton density weighted view. Xiphemu xa le mahlweni xa xiphemu lexi tshovekeke (nseve) xi khomanisiwile na angle ya le mahlweni ya meniscus (nseve). Xiya leswaku tikhoneni ta le ndzhaku a ti kombisiwi (*).

Swikumiwa swin’wana swa MRI:

Swikombiso swin’wana swa MRI swi tiyisisiwile, ku fana na ku pfumaleka ka bow tie, inverted meniscus sign, kumbe swiphemu swa meniscal leswi rhurheriweke hi ku kongoma eka ndhawu ya intercondylar eka swifaniso swa millimeter frontal (Fig. 9) kumbe axial.

Xifaniso xa 9 Xikhomo xa bakiti lexi hambanisiweke eka xilotlelo. Frontal PD-weighted view endzhaku ka ku tshikileriwa ka mafurha. Xiphemu xa meniscus lexi tshovekeke (nseve) xi hlangana na ACL (nseve).

Xikombiso xin’wana xa ximfumo xa ku nga tshamiseki ka meniscal i ku kumiwa ka ku rhurha ka le matlhelo ka swiphemu swa meniscal eka fimoral meniscal recess kumbe femoral-tibial recess. Ku rhurha loku ku katsa kwalomu ka meniscus ya swa vutshunguri naswona i xiphiqo xa timhangu tin’wana ta horizontal cleft eka 10% wa timhangu. Swiphemu swa coronal na transverse i ndlela ya kahle swinene yo vona swiphemu leswi.

Meniscus detachment .

Ku hambanisiwa ka meniscal swihumelela tani hi mbuyelo wa ku vaviseka lokukulu ka valgus naswona swivangiwa hiku phatluka ka meniscus’ capsular appendage. Leswi switala ku khumba rimhondzo rale ndzhaku ra meniscus yale xikarhi leri khomelelaka eka xiphemu xa nhlangano hiku tirhisa ku tiya ka xiphemu xa nhlangano (the posterior oblique ligament).

Swi endla leswaku kuva na 5 mm offset kuya eka meniscus yale henhla kusuka eka posterior border ya tibial plate eka swifaniso swa sagittal (Fig. 11), kumbe ku nghenisiwa ka fluid exikarhi ka base ya meniscus na plane ya joint capsule.

Xifaniso 11 Ku hambanisiwa ka rimhondzo ra le ndzhaku ra meniscus. Xifaniso xa ku tsindziyela ka proton ya Sagittal. Meniscus leyi hambanisiweke yi rhurhisiwa emahlweni. Kuna ndzhawu leyikulu ya hyperintensity (*) exikarhi ka xisekelo xa meniscus na posterior capsule (nseve).

Meniscus leyi papamalaka .

Leswi swivangiwa hi ku vaviseka ka tihanyi naswona swivangiwa hiku phatluka ka meniscal-tibial ligament xikan’we naku hambanisiwa ka xiphemu xale xikarhi xa meniscus. Eka MRI, meniscus leyi hambanisiweke yi rhendzeriwe hi ku helela hi mati naswona yi vonaka yi 'float' eka tibial plateau (Xifaniso 12).

Xifaniso xa 12 Ku papamala Meniscus. Xifaniso xa frontal proton density lexi nga na saturation ya mafurha. Meniscus leyi hambanisiweke yi rhendzeriwe hi mati, ngopfu ngopfu exikarhi ka vuandlalo bya yona bya le hansi na tibial plateau (nseve).

Meniscus ya le ndzhaku ka vuhandzuri .

Ku vava loku tlhelaka ku va kona endzhaku ka meniscectomy ku tisa swiphiqo swo tala swa vukamberi: ku pandzeka loku tlhelaka ku va kona, endzhaku ka ku pfimba ka khwiri, chondrolysis, subchondral necrosis, kumbe arthralgia. MRI yi tala ku tsandzeka ku vona ku avana loku tlhelaka ku va kona hikuva meniscectomy yi siya ti-hyperintensities ta le xikarhi leti 'wrongly' ti vulavurisana na vuandlalo bya meniscus. Nchumu wun’we ntsena lowu kumiweke lowu a wu tekiwa wu ri wa vuvabyi naswona wu hlamuseriwa tanihi ku rhendzeleka loku vuyeleriwaka a ku ri fluid intrameniscal hyperintensity eka swifaniso leswi pimiweke hi T2. Swipimelo leswi swa MRI yo olova ntsena swi susumetele vatsari van’wana ku ringanyeta ku tirhisiwa ka MRI arthroscopy, hambi leswi nakambe vuyelo bya kona laha byi nga fambisaniki.

Ndlela Yo Xava Switirhisiwa Swa Marhambu Na Switirhisiwa Swa Marhambu.

Swa CzMediTech , hi na layini ya swikumiwa leyi heleleke swinene ya switirhisiwa swa vuhandzuri bya marhambu na switirhisiwa leswi fambelanaka na swona, switirhisiwa ku katsa na . Swilo leswi nghenisiwaka hi nkolo ., Swipikiri swa le ndzeni ka khwiri ., Xiphepherhele xa khombo ., Xiphepherhele xo pfala ., Cranial-maxillofacial ., Prosthesis ., Switirhisiwa swa Matimba ., Vahlayisi va le handle ., Arthroscopy ., Nkhathalelo wa Swiharhi na tisethi ta vona ta switirhisiwa swo seketela.

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