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膝外下动脉与外侧半月板解剖关系的MRI研究

         

摘要

Objective To investigate the MRI findings on the anatomical relationship between lateral genicular artery and lateral meniscus and its clinical significance. Methods Two fresh frozen cadaveric knee joints were used to generally observe the pathway of lateral genicular artery and its relationship with the lateral meniscus. And then 100 patients, who received MRI on the knee joints from March to June 2010, were optionally selected and enrolled into this study. With the coronal section MRI image of the popliteal tendon layer as a standard, we measured 5 -7 layers forwardly, and then determined the vitical and horizontal distance between the lateral genicular artery and lateral meniscus. Results The MRI study showed that the anatomical relationship between the lateral genicular artery and lateral meniscus was relatively fixed, consistent with the cadaveric knee joints. The artery winded close to the lateral meniscus from posterior inferiorly to anterior superiorly. In the popliteal tendon layer, 98% of the lateral genicular arteries located at or below the lower edge of the lateral meniscus. In layer five (about anterior-middle body of the meniscus) , 89% of the arteries located at or above the middle of meniscus. The average horizontal distance between the two was 0. 8 mm (0-3 mm). Conclusions The lateral inferior genicular artery winds laterally close to the lateral meniscus. It is possible to damage this artery at the time of surgery for lateral meniscus. It is imperative that the surgeon be aware of this anatomy to reduce postoperative complications.%目的 探讨膝外下动脉与外侧半月板解剖关系的MRI表现及其可能的临床意义. 方法 先通过2例膝关节新鲜冰冻尸体标本大体上观察膝外下动脉的走行及其与外侧半月板的关系.随意选择2010年3~6月门诊膝关节MRI检查100例,以MRI冠状面的腘肌腱层为标准,向前测量5~7个层面,测量膝外下动脉与外侧半月板之间的垂直及水平距离.结果 100例MRI冠状面显示膝外下动脉的走行相对固定,与膝尸体标本的大体观察一致.在腘肌腱层,98%的膝外下动脉开始贴近外侧半月板,位于半月板下缘或下方;随着层面向前,膝外下动脉紧贴外侧半月板自后下向前上走行;在第5层(约半月板前体部),89%的膝外下动脉位于外侧半月板中部及以上;在第7层(约半月板前角及脂肪垫区),100%的膝外下动脉位于半月板上方;在第1~5层,膝外下动脉与外侧半月板的平均水平距离为0.8 mm(0~3 mm). 结论 膝外下动脉与外侧半月板(尤其是体部)的距离非常接近,在关节镜外侧半月板手术时容易损伤此动脉,增加对于这一解剖的认识,可能减少术后并发症.

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