Ungayisebenzisa kanjani i-MRI ukuthola ukuthi i-KNINE Meniscus kanye nokulimala kwe-ligament?

I-Meniscus iyi-fibrocartilage enobumba ama-meniscus ngesigaba sesiphambano se-trianus esisendaweni ephakathi kweTibial Condom kanye nethafa, elithuthukisa kakhulu ukuvumelana okuhlangene kwe-temoro-tibial futhi kudlala indima ebalulekile ku-Dynamics ehlanganyelwe.

Okutholakele okujwayelekile nokungajwayelekile kwe-MRI

Ezithombeni zakwaSagittal nezangaphambili, i-meniscus ejwayelekile iyinxantathu e-hypypense. Esithombeni sakwa-sagittal esiningi kakhulu, i-meniscus yisakhiwo 'somnsalo

Umdwebo 1 Ukubukeka kwe-MRI okujwayelekile kwe-Menical Meniscus. I-Proton Density-Sisindo ebukwayo yeSagittal: Ama-angles angaphandle namanje angemuva ama-angles asemanzi angenamqondo angenazinhlanga ze-hypoinenseouse. I-meniscus ibunjiwe futhi iqukethe izingxenye zesigaba esiphakathi esixhuma izimpondo zalo ezingaphandle phambi kwazo nezimpondo zalo zangemuva ngemuva kwayo.

Kuyasiza ukuqonda izinto ezithile zokuhlukumezeka ezingezwayo njengoba zingalingisa ukwahlukana okushiwo:

• Esigabeni seSagittal, uguquko phakathi kwama-ligaments aguqukayo nangongaphandle;

• I-Popliteal Tendon Sheath;

• UHumphrey no-Wrisberg's Meniscus-Womeral Ligament baxhuma uphondo lwangemuva lwe-meniscus yamuva e-Medial Femoryleyle;

• I-Oblique Meniscus Ligament, ngezikhathi ezithile ezixhuma uphondo lwangaphandle lwamanzi kuphondo lwangezinduna zalo meniscus olungaphambene, angalingisa ukufuduka kwamanzi noma isibambo se-barrel

• I-Discoid Meniscus ingukukhubazeka kwe-meniscus okuvamile. Le dysplasia yasemeniscal ithinta cishe i-meniscusus yakamuva. Ukuxilona kwalo 'akwezemfundo Lokhu okutholakele kulungiswe ngokususelwa kuzilungiselelo ezithile ezisetshenzisiwe.

Umdwebo 2 Discoid maniscus we-lateral. Isithombe se-sagittal T1-sisindo. Ukuqhubeka kwamakhona ngaphambili nangemuva ezingxenyeni ezi-3 ezilandelanayo ezingama-5mm. Qaphela ukonakala kwe-myxoid kophondo lwangaphandle lwale discoid maniscus.

I-Meniscus Pathology Imaging

Kuyinto ejwayelekile ukuzihlukanisa ngokuyisisekelo phakathi kwamanzi abuhlungu namanzi okuwohloka. Umphumela wokulimala kabi kusuka ekusetshenzisweni kwamandla okweqile kwemishini kuma-meniscus anempilo. Kwebadala abadala, i-fisure ivame ukubangelwa ukulimala kwe-valgus engaqondile, ukuphakama okungekuze kwe-tibia ngemuva kokujikeleza kwangaphandle noma i-hyperflexion yedolo ngo-20 ° wokuguquguquka. Esikhundleni salokho, ukuwohloka kwenzeka ngenxa yamandla ajwayelekile emishini asebenza kuma-meniscus alimaze amandla e-arstitial myxoid degeneration. Izisekelo ze-Menical Meniscal zingahle zikhule ngokuzenzakalelayo noma zingadalwa ukulimala okuncane.

Ukuhlela ngohlobo oluthile

Ngokusho kokuqondisa kwendiza ye-cleavage, ama-fissures angahlukaniswa ngemicibisholo evundlile, imicibisholo emile noma imichilo eyinkimbinkimbi

I-Fissure evundlile

Kukhona indiza ehlukaniswe ngokufana kwethafa leTibial elihlukanisa ama-meniscus abe izingxenye eziphakeme nezingaphansi. Lezi zilonda ezivundlile zigcwele, zingathinta kakhulu ama-meniscusus aphakathi noma alandelanayo, futhi zithathwa njengezinzile, yize imfucumfucu efudukela kwi-groove ngemuva kokulimala kwe-meniscus medic.

Ukuvala umlomo mpo

I-perpendicular endizeni ye-tibial kanye nokujikeleza kwamanzi. Lokhu kuvame ukuthinta ama-meniscusus aphakathi nendawo. Ukulimala okuphelele kubhekwa kungazinzile futhi kuhlukanisa ama-meniscus abe izingxenye eziphakathi nendawo nakwamuva. Izinga lokuskena libuye lifake umzimba we-meniscus lateral kanye nophondo lwangemuva lwe-meniscus, okulula ukuvezwa kabi njenge-barrel patbang izinyembezi, okungenzeka kwenzeke lapho kuhlanganiswa nedolo. Kuhlanganiswe nezithombe ze-sagittal, izinyembezi ze-barrel patbang zingakhishwa (isithombe 3).

A. I-MRI yeCoronal Mri, umcibisholo ukhomba uphondo lwangemuva lwe-meniscus laterali, okulula ukubangelwa kabi njengomgqomo wokubamba inkunzi; B. Lapho wenza ukuskena kwe-MRI ngokusho kwesikhundla esiboniswa umugqa wamachashazi kulesi sibalo, kuzovela izinyembezi ze-pseudo bamba izinyembezi.

Imisebe ye-Radial Fissures iyinhlanganisela ye-perimeter ye-meniscus futhi ivame ukuthinta umphetho wamahhala we-meniscus.

I-Parrot Beak izinyembezi

Ingabe umonakalo oxubile omile oqukethe ingxenye ende ende kanye nengxenye ye-radial edlulela emaphethelweni amahhala.

Ekugcineni, kukhona ukulimala okuyinkimbinkimbi okwenziwe ngesandla, ngaphandle kwencazelo ecacile, efaka ama-Fissures amaningi avundlile nawo aqonde mpo.

Ukubonakaliswa kwe-MRI kokulimala kwe-meniscus

UMeniscus Wehlela

Stoller et al. Kuphakanyisiwe amamaki ama-3 we-Meniscus (Umdwebo 4)

Ibanga 1: I-Hyperintlenity nodur meniscus egcinwe ebusweni be-meniscus;

Ibanga lesi-2: Isiginali ephezulu yesiginali meniscus egcinwe ebusweni be-meniscus;

Ibanga 3: I-Hyperintnsity ifinyelela endaweni eyodwa ye-meniscus.

Umdwebo 4 Stoller Scale. A: Ibanga 1: I-HYPERIRENT eyodwa ye-hyperintnity amasayithi ahambisana nobuntu be-meniscus; B: Ibanga 2: Linear Intermediate hyperintency on the arturical of the Meniscus; C: Ibanga 3: I-Linear Intermediate hyperintlensity inwebeka ebusweni be-meniscus.

Yize umehluko phakathi kwamaBanga 2 no-3 anesizotha, ahlukanise i-hyperincensity ye-intramenicality ye-intramenicalscal (Umdwebo 5) kusuka emithini yangempela. Lokhu kwehlukaniswa phakathi kwe-meniscus ewohlokayo futhi edwenguliwe akuyona iqonde njalo, futhi kunemithombo eminingi yephutha ngenxa yokubonakala okwengeziwe noma okungekho.

Umdwebo 5. Ukubukeka okuwohloka kwamanzi. Ukubukwa kwe-Sagittal desity destity nge-fat saturation. Izindawo eziphakeme zesiginali zingabonakala ngaphandle kwesithombe sangempela somugqa weqiniso.

Izinyathelo zokuzivikela:

I-MRI inokusebenza okuhle kakhulu, ngokuzwela nokucaciswa okuphakathi kuka-90% no-95%. E-MRI, i-cleft ye-meniscal ivela njengokwandiswa komugqa omaphakathi kwe-hypymerence kwenye yezindawo ezibonakalayo ze-menicus (i-stoller grade 3), noma ukuhlukunyezwa okuhlanzekile kwe-morphological.

Lapho izinyembezi zibonakala kuphela kucezu elilodwa, kukhona ubunzima, ikakhulukazi ubungozi obukhulu bemiphumela emihle yamanga. Uma i-hyperintlenity ngaphakathi kwama-meniscus aqondile ithinta kakhulu indawo engaphezulu, okungukuthi okungenani ezingxenyeni ezimbili eziseduze, kunconywa ukuthi kubhekwe njenge-pathological. Lo mqondo kufanele uguqulwe ngokuya ngenqubo yokutholwa kwesithombe esetshenzisiwe (izigaba ezi-3 kuya kwezi-4 mm noma ukuthola ivolumu ye-3D ngezigaba ze-isotropic MM).

I-radial meniscal clefts kwesinye isikhathi kunzima ukuyixilonga, inikezwe ukuqondiswa kwayo. Lokhu ikakhulukazi kuholela ekuhlazisweni kwe-morphological:

• Ukuphazamiseka kwamahhala noma ukunqunywa kwesithombe esingaphambili;

• Ukubukeka okungahleliwe noma okuncishisiwe kwe-Meniscus Bowtie esithombeni sakwaSagittal (Umdwebo 6);

Umdwebo 6. I-Radial Fissure engxenyeni engaphandle ye-Menical Meniscus ekubukeni okuyisisekelo kwe-sagittal desitton. Ukubukeka okujwayelekile kwe-Medial Meniscus dencted Bow Tie (umcibisholo).

• I-meniscus elahlekile noma

Ukuqhuma kwama-meniscus ngesibambo sebhakede kuhlanganisa cishe u-10% wokunweba ama-spondyloticthesis. Kulokhu, ukuzwela kwe-MRI kucishe kube ngu-70%, kuya ngenqubo yokuxilonga esetshenzisiwe.

Ukutholwa kwe-MRI okudinga ukunakwa:

Ukuthola okuvame kakhulu ukubonwa okuqondile kwezingcezwana ezifudukayo esifundeni se-Intercondylar: I- 'ephakemeyo Ingxenye evunyelwe ivele njengebhande le-arcuate hypyoinense parallel lihambisana ne-ligament evamile ebabazekayo, ekhiqiza ukubukeka kwe- '' (umdwebo Izimpondo ze-Rune ezikhulu ngokweqile (ngaphezulu kwe-6 mm ngosayizi) zingakhombisa nokuba khona kwesibambo se-barrel (Umdwebo 8). Kulokhu, izingcezu ze-meniscus ezihanjisiwe zinamathele kuphondo elinempilo elingaphandle.

Umdwebo 7 Ukuvela kwesibambo se-Medical Meniscus kunesibonakaliso se- '' '. Ukubukwa kwesisindo se-sagittal nge-sagittal ngokucindezela kwamafutha

Umdwebo 8 Ukuvela kophondo lwangaphambili olukhulu. I-Sagittal Proton density Viensity View. Ingxenye engaphandle yesiqephu esakhishwe (umcibisholo) inamathiselwe kwi-anterior meniscus angle (umcibisholo). Qaphela ukuthi amakhona angasemuva awakhonjiswa (*).

Okunye okutholakele kwe-MRI:

Ezinye izimpawu ze-MRI ziqinisekisiwe, njengokuthi ulahlekelwe umnsalo we-Bow Bow, uphawu lwe-meniscus olungenayo, noma izingcezwana ezikhathini ezifulelwe isifunda ngokuqondile esifundeni se-intercondylar emigidini yeminyaka (i-Fig. 9) noma izithombe ze-axial.

Umdwebo 9 Ukwabelwa Phatha Blukhonkwane Ku-Slot. Ukubuka okunesisindo kwe-PD ngemuva kokucindezela kwamafutha. I-Meniscus Franced Meniscus (Arrow) ixhumana ne-ACL (Arrow).

Olunye uphawu olusemthethweni lokungazinzi okushiwo yi-meniphel ukuphazamiseka kokuthuthwa kwe-periscal kwezingcezwana zasemanzini ku-femor deserment recess noma i-femoral-tibial recess. Lokhu kudonswa kuhilela cishe kuphela ama-meniscusus wezokwelapha futhi kungukuphazamiseka kwamacala athile avundlile ku-10% amacala. Izigaba zeCoronal nezentengezelo ziyindlela engcono kakhulu yokuthola lezi zingcezwana.

Dengwane Meniscus

Ukuqunjelwa okwenziwe ngumenyulwa kwenzeka ngenxa yokulimala okunzima kwe-VALGUS futhi kubangelwa ukuqhekeka kwe-meniscus 'capsur appendage. Lokhu kuvame ukuthinta uphondo lwangemuva lwe-meniscus ye-medial enamathisela kwi-capsule ehlanganisiwe ngokusebenzisa ukuqina kwe-capsule ehlanganisiwe (i-abterior oblique ligament).

Baphumela ekuhambeni kwama-meniscus aphezulu asuka kuma-meniscus aphakeme avela emngceleni wangemva kwepuleti ye-tibial ezithombeni ze-sagittal (Fig. 11), noma ukufakwa kwamanzi phakathi kwesisekelo se-meniscus nendiza ye-capsule ehlanganisiwe.

Umdwebo 11 Ukuqunjelwa kophondo lwangemuva lwe-meniscus. Ukubukwa kwe-sagittal desity. Ama-meniscus ahlukanisiwe asuswa ngaphandle. Kunendawo enkulu ye-hyperintensity (*) phakathi kwesisekelo se-meniscus kanye ne-capsule engemuva (umcibisholo).

Ama-meniscus antantayo

Lokhu kungumphumela wokulimala okunobudlova futhi kungenxa yokuqhekeka kwe-ligament ye-shigament yasendulo kanye nokuvalwa kwengxenye yempilo yama-meniscus. E-MRI, i-meniscus ehlukanisiwe izungezwe ngokuphelele uketshezi futhi ibonakala i- 'float ' ku-tibial plateau (Umdwebo 12).

Umdwebo 12 ama-meniscus antantayo. Ukubuka okungaphambili kwe-proton density nge-fat saturation. I-meniscus ehlukanisiwe izungezwe uketshezi, ikakhulukazi phakathi komhlaba wayo ophansi kanye nethafa leTibial (umcibisholo).

I-Miniscus Postoperative

Ubuhlungu obujwayelekile ngemuva kokuthi i-Menisclectomy iveza ubunzima obuningi bokuxilonga: imicibisholo ephindaphindayo, i-postmeniskectomy, i-chondcondsis, i-subchindral necrosis, noma i-arthralgia. I-MRI imvamisa yehluleka ukuthola imichilo ephindaphindwayo ngoba ama-meniskectomy ashiya ama-hypercensities aphakathi nalo 'ngokungafanele ' ukuxhumana nomuntu osemanzini. Ukuphela kokuthola okubhekwa njengokuphayona nokuhunyushwa njenge-fissure ephindaphindayo kwakuwuketshezi lwe-intrameniscals hyperintsnity ezithombeni ezinesisindo se-T2. Lokhu kulinganiselwa kwe-MRI elula yedwa kudale abanye ababhali ukuthi bahlongoze ukusetshenziswa kwe-MRI Arthroscopy, yize imiphumela lapha ayihambelani.

Ungayithenga kanjani izimila zamathambo namathuluzi ama-orthopedic?

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