《积水潭膝关节MRI》PPT课件

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1、PracticalInterpretationofKneeMRIRoutineMRIprotocolSagittal,Coronal,AxialSpinecho(SE)FSE,STIRT1,T2,PDJSTCoronal:T2FFET2STIRSaggital:T1T2T2FFET2STIRTR和TE决定成像加权短TE长TE短TRT1无用途长TRPDT2T1weightedimage(TR<1000msec,TE<40msec)“anatomy”T2weightedimage(TR>1500msec,TE>60msec)“pathology”Fatsuppre

2、ssionChemicalsaturationShorttauinversionrecovery(STIR)TissuecharacterizationT1T2AdiposetissueFatwhitegrayYellowmarrowWaterdarkwhiteCorticalboneblackblackCartilagegraygrayTendon/ligament/meniscusblack/grayblack/grayMusclegraygrayHematomawhitewhiteChronichemorrhagedarkdarkAnteriorCruc

3、iateLigamentextensionER15°—20°NormalMRappearancedirectsignoftornACLdiscontinuityabnornalorientation(fallenACL)nonvisualizationAvulsionfxIndirectBonebruisesignDeepsulcussignSegondfxgeneralizedincreaseinsignalintensitythicknessincreaseAnteriordrawersignAcutehemarthrosisBucklingofPCLp

4、ivot-shiftpatternKissingsignSegondsignDeepsulcussign>2mmgeneralizedincreaseinsignalintensitythicknessincreaseBucklingofPCLnonspecificAnt.drawersignAssociatedsofttissueinjuriesPosteriorhornofmedialmeniscusBuckethandletearMCLPosteriorCruciateLigamentNormalMRappearanceMeniscus-Femorall

5、igamentPrimarysignofPCLcompletetearpartialtear“peeloff”injuryCompletetearGrade1Grade3Grade2partialtearSecondarysignofPCLinjurybonemarrowedema(BME)avulsionfxDashboardinjurysignBoneMarrowEdemaTibialavulsionfxAssociatedligamentinjuryACLinjuryMCLinjuryPLC/LCLinjuryCollateralligamentNo

6、rmalAnatomyofMCLGradingMCLInjuriesGrade1(sprain)Grade2(partialtear)Grade3(completetear)NormalAnatomyoftheLCLComplex/PosterolateralCornerComplexIliotibialbandLCLPoplitealm.complexBicepstendonVisibledisruptionofoneoftheposterolateralcapsulestructuresExtensivesurroundingsofttissueedema

7、AvulsionfractureormarrowedemainvolvingthemedialaspectofthefibularheadSignsofPosterolateralCornerInjuryMeniscibowties<2triangularrectangularCriterialtodetectmeniscalteargrade3signalabnormalmeniscalmorphologydisplacedormissingmeniscaltissuemeniscocapsularseparationGradeIIImeniscustear

8、missingfragmentDisp