半月板病变的MR诊疗课件.ppt

半月板病变的MR诊疗;正常半月板解剖;正常半月板解剖;正常半月板解剖;正常半月板解剖;正常半月板功能;正常半月板MR表现;蝶形结构;体部中央宽度小于15mm，中心部高度小于3mm;;半月板MR检查的目的;半月板病变分类;半月板损伤的分度;半月板损伤分度;MRI,2008:567-571;I度退变;II度退变;III-A型撕裂;III-B型撕裂;;IV度撕裂;半月板撕裂;半月板撕裂;An accurate description of a meniscal tear;半月板撕裂分型;Classification of tears ;Horizontal tears;;Vertical longitudinal tear;Vertical radial tear;Vertical radial tear;Vertical parrot-beak tears;斜行撕裂;桶柄状撕裂（bucket handle tear）;提示残留碎片的征象 领结征缺如 冠状短截征 提示内移的碎片的征象 双后交叉韧带征 The double PCL sign 双前角征 半月板翻转 髁间窝碎片 后角形态异常 诊断标准为同时出现任一提示残存半月板征象和提示内移碎片的征象;桶柄状撕裂;双半月板前角征 冠状短截征 髁间窝碎片;蝶形领征消失 髁间窝碎片征;A bucket handle tear involving the medial meniscus (arrows) There was also a complete tear of the ACL ;integrity of the posterior horn medial meniscal root ;bucket handle tear;B:FSE-T2Wa prominent radial tear (arrow). ;双后交叉韧带征;半月板撕裂与ACL撕裂;半月板撕裂的诊断效能;注意的问题;半月板撕裂的诊断误区;假阳性;假阴性;Meniscal extrusion半月板外突、疝、周缘性移位;;冠状交叉韧带层面，半月板边缘超过胫骨股骨连线外缘3mm以上 在半月板退变的患者中更常见 外侧半月板和体部突出是正常变异，突出超过1mm为异常 与软骨异常和OA有关;Skeletal Radiol 2004;33:569–74.;AJR 2004; 183:17-23;47-year-old man with radial tear involving meniscal root with major extrusion ;fat suppressed T2 shows extrusion of the medial meniscus (curved arrow) and small adjacent areas of focal marrow edema (straight arrows). The medial meniscus has a degenerative horizontal cleavage tear approximating the tibial surface. Note also the moderate loss of hyaline cartilage ;半月板疝;半月板囊肿;半月板囊肿的MR表现;Intrameniscal cysts Small lesions of fluid signal within the meniscus Focal enlargement of the meniscus An adjacent horizontal cleavage tear ;;;;半月板周围囊肿;盘状半月板;MR diagnosis;;;盘状半月板;盘状半月板;盘状半月板;盘状半月板;谢谢！