《积水潭膝关节MRI》PPT课件.ppt

PracticalInterpretationofKneeMRI,RoutineMRIprotocol,Sagittal,Coronal,AxialSpinecho(SE)FSE,STIRT1,T2,PD,JST,Coronal:T2FFET2STIRSaggital:T1T2T2FFET2STIR,TR和TE决定成像加权,短TE长TE短TRT1无用途长TRPDT2,T1weightedimage(TR60msec)“pathology”,FatsuppressionChemicalsaturationShorttauinversionrecovery(STIR),Tissuecharacterization,T1T2AdiposetissueFatwhitegrayYellowmarrowWaterdarkwhiteCorticalboneblackblackCartilagegraygrayTendon/ligament/meniscusblack/grayblack/grayMusclegraygrayHematomawhitewhiteChronichemorrhagedarkdark,AnteriorCruciateLigament,extensionER1520,NormalMRappearance,directsignoftornACL,discontinuity,abnornalorientation(fallenACL),nonvisualization,Avulsionfx,Indirect,BonebruisesignDeepsulcussignSegondfxgeneralizedincreaseinsignalintensitythicknessincreaseAnteriordrawersignAcutehemarthrosisBucklingofPCL,pivot-shiftpattern,Kissingsign,Segondsign,Deepsulcussign,2mm,generalizedincreaseinsignalintensitythicknessincrease,BucklingofPCL,nonspecific,Ant.drawersign,Associatedsofttissueinjuries,PosteriorhornofmedialmeniscusBuckethandletearMCL,PosteriorCruciateLigament,NormalMRappearance,Meniscus-Femoralligament,PrimarysignofPCL,completetearpartialtear“peeloff”injury,Completetear,Grade1,Grade3,Grade2,partialtear,SecondarysignofPCLinjury,bonemarrowedema(BME)avulsionfx,Dashboardinjurysign,BoneMarrowEdema,Tibialavulsionfx,Associatedligamentinjury,ACLinjuryMCLinjuryPLC/LCLinjury,Collateralligament,NormalAnatomyofMCL,GradingMCLInjuries,Grade1(sprain),Grade2(partialtear),Grade3(completetear),NormalAnatomyoftheLCLComplex/PosterolateralCornerComplex,Iliotibialband,LCL,Pplex,Bicepstendon,VisibledisruptionofoneoftheposterolateralcapsulestructuresExtensivesurroundingsofttissueedemaAvulsionfractureormarrowedemainvolvingthemedialaspectofthefibularhead,SignsofPosterolateralCornerInjury,Menisci,bowties2,triangular,rectangular,Criterialtodetectmeniscaltear,grade3signalabnormalmeniscalmorphologydisplacedormissingmeniscaltissuemeniscocapsularseparation,GradeIIImeniscustear,missingfragment,Displacedfragment,smallPHMM,MRIsigns,absentbowtiessign(1orfewer)doublePCLsignlargeanteriorhornsigntoomanybowties(3ormore)notchsign,Large°enerationant.horn,3ormorebow-ties,Buckethandletear,doublePCLsign,discoidmeniscus,3ormorebow-ties,Pitfallsinmeniscusdiagnosis,GradeIIsignalTransversemeniscuslig.PoplitealhiatusMeniscofemorallig.BursaorfatplaneofMCL,Poplitealhiatus,内侧半月板后角的上隐窝垂直光滑不连通,PostoperativeMeniscus,Grade3signalonT1-weightedimagesonlyisindeterminatefortear:itmayrepresentpostoperativechangeorretearofthemeniscusGrade3signalonaT1-weightedimagethatisbrightasfluidonaT2-weightedimageisdiagnosticofretear.Adisplacedmeniscalfragmentisdiagnosticofretear.Grade3signalinnewalocationisdiagnosticofretear,BoneMarrowEdema(BME),pivot-shiftinjurydashboardinjuryhyperextensioninjury:”kissingsign”clipinjurypatellardislocation,clipinjury,patellardislocation,OCD,