CAJ | 학술논문

目的对冰冻膝关节前交叉韧带(ACL)斜冠状面薄层解剖断面与正常人膝关节MRI特点进行对照研究,为ACL损伤分级诊断建立基础.方法 1例(1只)膝关节标本行斜冠状面MRI确定角度,冰冻后沿斜冠状面1 mm层厚铣切,观察ACL薄层解剖特点.选择50名正常人对其ACL进行MR斜冠状面扫描,观察ACL的MRI特点.结果 1只膝关节标本的ACL在斜冠状面薄层断面清晰显示其全程走行,清晰地显示ACL前内束与后外束,前内束从股骨髁附着点后上方区自后向外侧及前内侧走行,止于髁间棘附着区前内侧方,后外侧束从股骨髁附着点前下方区,自后外侧及外下走行,止于髁间棘附着区后外侧方.斜冠状面MRI能够显示50名正常人ACL全程,显示率为100%.MRI能够区分ACL前内束与后外束结构,显示前内束自后外侧向前内走行,止于髁间棘附着区前内侧方,后外束自后外侧向外下走行,止于髁间棘附着区后外侧方.MRI显示ACL走行与薄层断面显示的走行一致.结论斜冠状面是观察ACL的最佳方位,临床对怀疑ACL损伤的患者必要时行MR斜冠状面扫描.
목적 대빙동슬관절전교차인대(ACL)사관상면박층해부단면여정상인슬관절MRI특점진행대조연구,위ACL손상분급진단건립기출.방법 1례(1지)슬관절표본행사관상면MRI학정각도,빙동후연사관상면1 mm층후선절,관찰ACL박층해부특점.선택50명정상인대기ACL진행MR사관상면소묘,관찰ACL적MRI특점.결과 1지슬관절표본적ACL재사관상면박층단면청석현시기전정주행,청석지현시ACL전내속여후외속,전내속종고골과부착점후상방구자후향외측급전내측주행,지우과간극부착구전내측방,후외측속종고골과부착점전하방구,자후외측급외하주행,지우과간극부착구후외측방.사관상면MRI능구현시50명정상인ACL전정,현시솔위100%.MRI능구구분ACL전내속여후외속결구,현시전내속자후외측향전내주행,지우과간극부착구전내측방,후외속자후외측향외하주행,지우과간극부착구후외측방.MRI현시ACL주행여박층단면현시적주행일치.결론 사관상면시관찰ACL적최가방위,림상대부의ACL손상적환자필요시행MR사관상면소묘.
Objective To compare the normal anatomy of the anterior cruciate ligament (ACL) of fresh frozen cadaveric knee specimen in oblique coronal thin-slice section with oblique coronal magnetic resonance imaging. Methods One fresh cadaveric knee specimen was scanned with MR T1-weighted spinecho sequence.then the specimen was frozen and sliced with a band saw along the oblique coronal plane into 1.0-mm-thick sections that corresponded to the MR images,MR images including oblique coronal T1-weighted and T2-weighted images of 50 normal the knee joints were retrospectively reviewed to observe the MR imaging features of the cruciate ligament. Results Anteromedial and posterolateral bundles of ACL were clearly depicted on both anatomic slices and MR images.The anteromedial bundles originated from the posteromedial aspect of the lateral femoral condyle,coursing through the lateral intercondylar notch in an anterior,inferior,and medial direction,and inserted on the anteromedial aspect of the intercondylar eminence. The posterolateral bundles originated from the anteromedial aspect of the lateral femoral condyle,passing laterally and inferiorly through the lateral intercondylar notch,and inserted on the posterolateral side of the intercondylar eminence.The full length of ACL of all 50 individuals was showed on MR images.MRI clearly differenitated the anteromedial and posterolateral bundles of ACL and depicted the full length of the bundles.similar to the findings on sectional anatomy.Conclusion Oblique coronal MR imaging is the best way to demonstrate ACL and should be used for clinically suspected injury of ACL.