交叉韧带囊肿MR影像与临床表现分析_王雪松

:王雪松,Email:[e-mail];Tel:[phone]　　　MR王雪松　冯华　洪雷　张辉　耿向苏北京积水潭医院运动医学中心(北京100035)　目的:分析交叉韧带囊肿的MR影像和临床表现。方法:对7例交叉韧带囊肿患者进行回顾性分析,其中男性5例,女性2例。年龄22～38岁(平均年龄30.6岁)。对所有患者的临床表现,包括症状、症状持续时间、体征、外伤病史以及MR影像进行了分析。结果:本组病例有5例前交叉韧带囊肿和2例后交叉韧带囊肿,所有囊肿形态为椭圆形或分叶状。大多数位于交叉韧带的后方。采用关节镜手术对所有患者的囊肿进行切除和吸取,术后症状消失并且经过随访未出现复发。结论:膝关节内的交叉韧带囊肿较为少见。它可能造成膝关节疼痛,屈伸功能受限。MRI检查是有助于确立诊断、指导治疗的有效手段。这类损伤经过关节镜手术治疗可获得满意疗效。　交叉韧带;膝关节;囊肿;核磁共振AnalysisofMRFindingswiththeClinicalFeatureinPatientswithCruciateLigamentCystsWangXuesong,FengHua,HongLei,ZhangHui,GengXiangsuDepartmentofSportMedicine,BeijingJishuitanHospital,Beijing,China100035Abstract　ObjectiveToevaluatetheMRIfindingsofthecruciateligamentscystsincorrelationwithclin-icalfeature.MethodsSevenpatientswithcruciateligamentscystswerereviewed.Therewere5menand2women,agedfrom22to38years(mean30.6years).AllpatientswereexaminedbythekneeMRI.Theclin-icalmanifestationssuchassymptoms,durationofsymptoms,sign,andthehistoryoftraumawereevaluatedandthencorrelatedwiththeMRIfindings.ResultsFiveganglioncystswerefoundintheanteriorcruciateliga-mentsand2intheposteriorcruciateligaments.Allcystswereeitherovalorlobulatedinshape.Mostofthemwerelocatedalongtheposteriorsurfaceoftheligaments.Allcystswereresectedoraspiratedthrougharthroscopy.Aftersurgery,allpatientswereasymptomaticwithoutrecurrenceduringfollow-up.ConclusionIntraarticularcystsofthecruciateligamentsareuncommon.Itcancausekneepain,limitationofkneeexten-sionandflexion.TheuniqueMRimagesofthecystshelptodiagnosepatientswithchronickneepain,aswellastoplanthetreatment.Theresultsofarthroscopictreatmentforthecystsweresatisfied.Keywords　cruciateligament,knee,cyst,magneticresonanceimaging　　,。[1]。,[2],。7MR、,MR。1　200562006127,5,2。30.6(22～38)。MRI。T1(TR/TE360/14ms),T2(TR/TE3000/108ms)(TR/TE3360/79.7ms)、,5mm。、、、1。20075263ChinJSportsMed,May2007,Vol.26,No.3·275　　·1　Table1　Clinicalmanifestation编号性别/年龄/侧别症状症状持续时间(月)体征外伤病史囊肿部位1男/32/右疼痛,主动屈膝受限3个月无明显体征摩托车伤前交叉韧带后方2男/35/右疼痛,深蹲时加重12个月无明显体征无前交叉韧带后方3女/34/右疼痛,过伸和过屈加重5个月无明显体征无前交叉韧带后方4　女/26/右　疼痛,活动后加重　48个月　内侧间隙压痛　无　前交叉韧带后方为主;前方数个小囊肿5男/22/左疼痛,下蹲时加重25个月内侧间隙压痛无前交叉韧带后方6　男/38/左　疼痛,窝发胀;运动和下蹲时加重16个月　无明显体征　无　后交叉韧带周围　7男/26/左疼痛,下蹲时加重12个月无明显体征无后交叉韧带近端1/3　　,,。2　2.1　MR:,T1,T2(1)。5,2。,,,。,、(2)。2(3)。,。2.2　:,348。5,1;3;1,,;1;2。2,1;2,、。2.3　:7,。,,30°。,(4)。,。,(5)。、。,,。,(6)。1,(7),。2.4　:7,31。3　3.1　[2]。1924,Caan[3]。,Brown6500,35,0.54%[4]。McLaren1710MR15,0.88%[5]。8、32007,0.22%。3.2　。,Yasuda[6]。Kakutani1,[7]。,Levine[8]。Johnson11,3[9]。,,,1。MRI1/3,,　·276　　·20075263ChinJSportsMed,May2007,Vol.26,No.3,2/3,。,,。,。3.3　,Brown6500,35,29,6[4]。5,2。,[1,5,6]。。MRI,。,Baker,,,(8)。3.4　,,,。Huang,,。,、[1]。5,。,、。1。2,。。,。3.5　。:,,。,、。BrownBui-Mansfield50～78%[4,10]。。,348(17.3),,1。,。Kang。,[11]。Sumen。,,,[12]。1,,,,。3.6　,[10,13,14]。[14]。,[9]。CT[14,15]。[1,12]。7,30,,,,(9)。,,,,。4　,、。,:、,。,MRI、。,。5　[1]HuangGS,LeeCH,ChanWP,etal.Ganglioncystsofthecruciateligaments:MRfindingswithclinicalcorrelation.ActaRadiologica,2002,43(4):419-424.[2]BurkDLJr,DalinkaMK,KanalE,etal.Meniscalandgan-glioncystsoftheknee.MRevaluation.AmericaJournalofRa-diology,1988,150:331-336.[3]CaanP.Cystformation(ganglion)inananteriorcruciateliga-mentoftheknee.DtschZChir,1924,186:403-408.[4]BrownMF,ChirB,DandyDJ.Intra-articulargangliaintheknee.Arthroscopy,1990,6:322-323.[5]McLarenDB,BuckwalterKA,VaheyTN.Theprevalenceandsignificanceofcyst-likechangesatthecruciateligamentat-20075263ChinJSportsMed,May2007,Vol.26,No.3·277　　·tachmentsintheknee.SkeletalRadiol,1992,21:365-369.[6]YasudaK,MajimaT.Intra-articularganglionblockingexten-sionoftheknee:briefreport.JBoneJointSurgBr,1988,70:837.[7]KakutaniK,YoshiyaS,MatsuiN,etal.Anintraligamentousganglioncystoftheanteriorcruciateligamentafteratraumaticevent.Arthroscopy,2003,19(9):1019-1022.[8]LevineJ.Aganglionoftheanteriorcruciateligament.Surgery,1948,24:836-840.[9]JohnsonWL,CorzattRD.Ganglioncystoftheanteriorcruciateligament.Acasereportofanunusualcauseofmechanicalkneesymptoms.AmJSportsMed,1993,21:893-894.[10]Bui-MansfieldLT,YoungerbergRA.Intraarticulargangliaoftheknee.Prevalence,presentation,etiology,andmanage-ment.AmJRoentgenol,1997,168:123-127.[11]KangCN,KimDW,KimDJ.Intra-articularganglioncystsoftheknee.Arthroscopy,1999,15:373-378.[12]SumenY,OchiM,DeieN,etal.Ganglioncystsofthecru-ciateligamentsdetectedbyMRI.IntOrthop,1999,23:58-60.[13]Do-DaiDD,YoungerbergRA,LanchburyFD.Intraliga-mentousganglioncystsoftheanteriorcruciateligament.MRfindingswithclinicalandarthroscopiccorrelations.JComputAssistTomogr,1996,20:80-84.[14]NokesSR,KoonceTW,MontanezJ.Ganglioncystsofthecruciateligamentsoftheknee.RecognitiononMRimagesandCT-guidedaspiration.AmJRoentgenol,1994,162:1503.[15]DefriendDE,SchranzPJ,SilverDA.Ultrasound-guidedas-pirationofposteriorcruciateligamentganglioncysts.SkeletalRadiol,2001,30:411-414.(2007.02.26收稿;2007.03.14修回)(上接第274页)[7]KrischakG,HomigD,BeckA,etal.Evaluationofcartilagechangeswithinthescopeofsecond-lookarthroscopy12monthsaftersurgicalreconstructionofanteriorcruciateligamentrupture.Unfallchirurg,2001,104:629-638.[8]BarryM,ThomasR,ReesA,etal.Effectofanteriorcruciateligamentreconstructiononmeniscalandch