活體前交叉韧带MRI功能解剖学研究.docVIP

活体前交叉韧带MRI功能解剖学研究 陈新 潘晶晶 【摘要】目的 研究活体前交叉韧带（anterior cruciate ligment ACL ）功能解剖学的变化。方法 本组30例自愿者，共40侧膝关节，平均年龄23岁。应用3维MRI扫描序列，每个膝关节行4种体位扫描。膝伸直位（0°）和屈膝位（30°、60°、90°），经斜矢状和斜冠状面图像重建，测量ACL前内侧束（anteromedial bundle AMB）和后外侧束（posterolateral bundle PLB）长度和上倾角的变化，并观察解剖形态学变化。结果 随不同屈膝度AMB和PLB长度发生变化，屈膝90°AMB最长，张力最高。而PLB最短，张力最低。屈膝时AMB与PLB可形成平行结构型和绞扭结构型。膝伸直位时，AMB与PLB上倾角分别为38.5±4.9°和48.3±6.9°。结论 应用MRI技术可行ACL功能及解剖学研究。 【关键词】前交叉韧带；磁共振成像；功能解剖学 Functional anatomy of the anterior cruciate ligament in vivo with MRI CHEN Xin , PAN Jing-jing Department of Radiology ,General Hospital of Missile Army of PLA, Beijing 100088 【Abstract】 Objective To research the functional anatomic change of anterior cruciate ligament (ACL) In Vivo. Methods A total 40 knees from 30 healthy subjects , with mean age of 23 years， were studied to measure the length of the anteromedial bundle (AMB) and the posterolateral bundle (PLB) and to observe the change of the tension and the elevation angles and the architecture of AMB and PLB on oblique coronal and sagital images at different flexion of the knees（0°，30°，60°，90°）with MRI 3-dimensional multi echo data imaging combination(3D-MEDIC) sequence. Results When the knee is extended, PLB is tight and longer and AMB is moderately lax and shorter. As the knee is flexed to 60°-90°，AMB is to tighten and longer and PLB is to loosen up and shorter, meanwhile ACL displayed two types of the architecture : parallel type(22 cases) and twist type(18 cases). The elevation angles is 38.5±4.9° in AMB and 48.3±6.9° in PLB as the knee is flexed to0°. 【Conclusion】 It is feasible to make 3D-MEDIC of MRI to study the functional anatomy of ACL In Vivo. 【Key words】 anterior cruciate ligament,MRI, Functional anatomy 解剖学[1.2]和影像学[3.4.5.6.]研究表明，膝关节前交叉韧带（anterior cruciate ligment ACL）主要分为前内侧束（anteromedial bundle AMB）和后外侧束（posterolateral bundle PLB）。离体膝关节ACL功能解剖研究[7.8.9]表明。ACL的AMB和PLB 2束在膝关节不同屈伸状态下，其长度、张力、形态变化存在较大差异，功能作用不同。本文应用三维MRI扫描序列，对正常自愿者膝关节行不同屈伸状态下扫描。探讨生理状态下ACL 2束的结构形态变化。结合