前交叉韧带黏液样变性的MRI表现和伴随征象

摘要

Objective:The purpose of our study was to describe MR appearance and associated sings of anterior cruciate ligament mucoid degeneration. Materials and Methods:We reviewed 4540 knee MRI examinations in 3 years in our practice, all the knee MRI examinations were performed by two 1.5 T magnetic resonance machines. All the MR images were evaluated by two senior musculoskeletal radiologists by consensus. The diagnostic criteria for ligament mucoid degeneration and ganglia and intraosseous cysts based on the prior MRI features and arthroscopy. The incidence of ligament mucoid degeneration, MRI features of ganglion cyst (the size, complexity, location) and associated signs were recorded. Results: Of the 4540 knee MRI examinations, 34 (34/4540, 0.7%) had ACL mucoid degeneration, 13 (13/34, 38%) had discrete mucoid degeneration, and 21 (21/34, 62%) had features of both mucoid degeneration and ganglion cysts. Ganglia were located in the proximal ligament in 18 (86%) examinations and the distal ligament in 2 (9%) and involved the both proximal and distal ligament in 1 (5%). Ganglia ranged in maximum diameter from 6 to 30 mm (mean, 16 mm). 24 (24/34, 71%) cases had intraosseous cysts. 11 (11/34, 32%) cases present with severe osteoarthritis. Conclusions:Anterior cruciate ligament mucoid degeneration demonstrated characteristic“celery stalk sign”on MR imaging and commonly associated with ganglia and intraosseous cysts.%目的：探讨前交叉韧带黏液样变性的MRI表现与伴随征象。材料与方法回顾性分析3年内4540例膝关节MRI数据库，所有MRI检查由2台1.5 T磁共振机检查完成。由2名有多年经验的骨放射医师依据先前的MRI表现和关节镜结果诊断前交叉韧带黏液样变性、韧带腱鞘囊肿、骨内腱鞘囊肿，评价前交叉韧带黏液样变性的MRI特征表现以及与伴随征象的共存性。结果在所有4540例膝关节MRI中，34例(34/4540，0.7%)诊断为前交叉韧带黏液样变性，13例(13/34，38%)为前交叉韧带单独黏液样变性，21例(21/34，62%)为黏液样变性伴有韧带腱鞘囊肿，腱鞘囊肿最大直径平均为16 mm (最小6 mm，最大30 mm)，18例(18/21，86%)发生在近端，2例(2/21，9%)发生在远端，1例为近端与远端均有(1/21，5%)。24例(24/34，71%)伴有骨内腱鞘囊肿。11例(11/34，32%)伴有严重的膝关节骨性关节病。结论前交叉韧带黏液样变性在MRI上表现为特征性的“芹菜梗”征，多伴有韧带腱鞘囊肿和骨内腱鞘囊肿。