膝关节正常MRI解刨,,1.膝关节MRI正常解剖 2.膝关节常见疾病MRI,内 容,正常膝关节的骨、肌腱、半月板和韧带的通常呈无信号表现 关节软骨在各种序列中的信号各不相同,膝关节正常MRI表现,膝关节MRI,矢状位 冠状位 横断位,膝关节矢状面正常解剖MRI表现,特点： 1.可整段显像髌韧带、前后交叉、外侧韧副带结构，侧重的股胫软骨中部和半月板前后角 2.是诊断半月板撕裂或变性最为关键的断面 注：区分膝关节内外侧,胫骨头呈等腰三角形为内侧、呈高尔夫杆头状外侧,,内侧,,,,,,,外侧,矢状位解剖S-1,,,,缝匠肌,股骨内侧髁,腓肠肌内侧头,,大隐静脉,,股薄肌肌腱,Sag-2,,,,,,股内侧肌,缝匠肌,股骨内侧髁,股薄肌肌腱,腓肠肌内侧头,,半腱肌肌腱,,股薄肌,Sag-3,,,,,,,股内侧肌,缝匠肌,股骨内侧髁,内侧半月板,半膜肌肌腱,腓肠肌内侧头,,股薄肌,,半腱肌肌腱,Sag-4,,,,,,,,,缝匠肌,股内侧肌,半膜肌,内侧半月 板后角,股骨内侧髁,内侧半月板前角,胫骨内侧髁,腓肠肌内侧头,,半腱肌 肌腱,Sag-5,,,,,关节软骨,股内侧肌,半膜肌,比目鱼肌,,内侧半月板后角,,内侧半月板前角,,半腱肌,,股骨内侧髁,,胫骨内侧髁,,缝匠肌,Sag-6,,,,,股内侧肌,半膜肌,半腱肌,腓肠肌内 侧头肌腱,,比目鱼肌,,腓肠肌 内侧头,,,,内侧半月板后角,,关节软骨面,,,股骨内侧髁,胫骨内侧髁,Sag-8,,,股内侧肌,半膜肌,,腓肠肌 内侧头,,,腘肌,比目鱼肌,,关节软骨,,胫骨,,股骨,Sag-9,,,,,,,股四头肌,半膜肌,后交叉韧带,腓肠肌 内侧头,腘肌,比目鱼肌,,胫骨,,股骨,Sag-10,,,,,,,,股内侧肌,半膜肌,前交叉韧带,后交叉韧带,腓肠肌 内侧头,腘肌,比目鱼肌,,腓肠肌 内侧头,,胫骨,,股骨,Sag-11,,,,,,,血管搏动伪影,股内侧肌,半膜肌,髌骨,前交叉韧带,后交叉韧带,,腘肌,,腘斜韧带及 后关节囊,,板股韧带,,胫骨,,比目鱼肌,,髌下脂肪垫,,股骨远端,,胫骨近端,Sag-12,,股四头肌肌腱,,,,,髌韧带,髌下脂肪垫,髌骨,髁间隆起,,腘动脉,,腘静脉,,胫骨,,股骨,,腘肌,,股内侧肌,Sag-13,,,,,,腘肌,髌韧带,髌下脂肪垫,股四头肌肌腱,腓肠肌 外侧头,,股二头肌,,腘动脉,,血管,,比目鱼肌,Sag-14,,,,,,,,,股四头肌腱,外侧半月板前角,髌韧带,外侧半月板后角,腘肌及肌腱,股骨,股二头肌,,髌上脂肪体,跖肌,,比目鱼肌,,,髌骨及软骨,,髌下脂肪垫,Sag-15,,,,,,股四头肌肌腱,股二头肌,髌下脂肪垫,髌韧带,腓肠肌 外侧头,,,髌骨及软骨,,胫骨粗隆,,腘肌腱,,比目鱼肌,Sag-16,,,,,,髌韧带,股二头肌,股四头肌腱,腓肠肌 外侧头,,,关节软骨,,胫骨外侧髁,,腓骨,,股骨外侧髁,Sag-17,,,,,,股外侧肌,膝横韧带,腓肠肌外侧头肌腱,胫骨前肌,股二头肌,,外侧半月板 后角,,股四头肌腱,,髌韧带,,趾长伸肌,,,髌骨及软骨,Sag-18,,胫骨前肌,,股二头肌,,股外侧肌,,,腓肠肌 外侧头,,外侧半月板体部,,髌骨,,胫骨外侧髁,,腓骨近端,,股骨外侧髁,Sag-20,,股外侧肌,,,胫前肌,,腓肠肌外侧头,股二头肌肌腱,,腓骨头,,胫骨外侧髁,膝关节冠状面MRI解剖,特点： 1. 显示内外侧副韧带、腘肌和拱状韧带 有无信号和结构改变。
2.侧重关节胫股软骨的两边和半月板的体部 注：区分左右侧膝关节,内侧髁大于外侧髁,,,,左侧,右侧,膝关节冠状位Cor-1,,,,股四头肌腱,髌骨,髌韧带,,髌内侧支持带,Cor-2,,,,髌韧带,髌内侧支持带浅层,股内侧肌,,股四头肌腱,,髌骨,髌内侧支持带深层,,Cor-3,,,,股内侧肌,髌下脂肪垫,髌韧带,,股四头肌腱,,髌内侧支持带,,髌骨,Cor-4,,,,髌韧带,股内侧肌,股四头肌腱,,髌外侧支持带,,髌内侧支持带,,髌下脂肪垫,Cor-5,,,股内侧肌,股骨,,股外侧肌,,髌韧带,,髌外侧支持带,Cor-6,,股内侧肌,,股外侧肌,,髌外侧支持带,,髌韧带,,股骨,,髌下脂肪垫,Cor-8,,髂胫束,,股内侧肌,,股骨内侧髁,,股骨外侧髁,,胫骨粗隆,,股外侧肌,Cor-10,,髂胫束,,股内侧肌,,股骨,,胫骨,,股骨外侧 肌及肌腱,,内侧半月板前角,,胫骨前肌,Cor-12,,髂胫束,,股内侧肌,,股骨,,胫骨,,股骨外侧 肌及肌腱,,内侧半月板前角,,胫骨前肌,外侧半月 板前角,,,内侧副韧带,Cor-13,,髂胫束,,股内侧肌,,股骨,,胫骨,,股骨外侧肌,,内侧半月板前角,,胫骨前肌,外侧半月 板前角,,,趾长伸肌,,内侧副韧带,,后交叉韧带,,前交叉韧带,补充 : 同一层面骨解剖,,股骨内侧髁,,股骨外侧髁,,胫骨内侧髁,,胫骨外侧髁,,髁间窝,,,髁间隆起,,,关节软骨面,,Cor-15,,外侧副韧带,,股内侧肌,,前交叉韧带,,股骨外侧肌,,内侧半月板,外侧半 月板,,,趾长伸肌,,内侧副韧带,,后交叉韧带,,腘静脉,,股骨,,胫骨,,缝匠肌,,,腘动脉,Cor-16,,外侧副韧带,,股内侧肌,,前交叉韧带,,股骨外侧肌,,内侧半月板,外侧半月板,,,趾长伸肌,,内侧副韧带,,后交叉韧带,,,腘动静脉,,股骨外侧髁,,胫骨,,缝匠肌,,股二头肌,,腓肠肌内侧头肌腱,,腓肠肌外侧头肌腱,,外侧副韧带,Cor-17,,腓肠肌内侧头,,,,腓骨,,股二头肌 和肌腱,,腘肌,,腓肠肌内侧头,,缝匠肌肌腱,,半膜肌,,腘血管,股骨外侧髁,,股骨内侧髁,,腓骨长肌,比目鱼肌,,胫骨后缘,,外侧副韧带,,大隐静脉,,,Cor-18,,腓肠肌内侧头,,,,腓骨头,,股二头肌 和肌腱,,腘肌,,腓肠肌内侧头,,缝匠肌肌腱,,半膜肌,,腘血管,股骨外侧髁,,股骨内侧髁,,腓骨长肌,比目鱼肌,,胫骨后缘,,外侧副韧带,,大隐静脉,Cor-20,,,腓肠肌外侧头,,比目鱼肌,,腓骨头,,股二头肌 和肌腱,,腘肌,,腓肠肌内侧头,,缝匠肌肌腱,,半膜肌,,腘血管,膝关节横断面MRI解剖,1.是三维影像首选的方位，也是为了便于MRI与CT比较。
2.可准确地展现髌骨内外侧关节面横轴位Ax-1,,股四头肌腱,,股内侧肌,,髌上脂肪囊,,缝匠肌,,半膜肌,,股薄肌及肌腱,,半腱肌及肌腱,,,股二头肌,,腘动、静脉,,,股骨远端,,股外侧肌及肌腱,Ax-2,,股四头肌腱,,,髂胫束,股内侧肌,,髌上脂肪囊,,缝匠肌,,半膜肌,,股薄肌及肌腱,,半腱肌及肌腱,,,,腘动、静脉,,,大收肌肌腱,股二头肌,股外侧肌,Ax-4,,股四头肌腱,,,髂胫束,股内侧肌,,髌骨上缘,,缝匠肌,,半膜肌,,股薄肌及肌腱,,半腱肌及肌腱,,,,腘动、静脉,,,髌外侧支持带,股外侧肌,股二头肌,,股骨远端,Ax-5,,髌外侧支持带,,,髂胫束,股内侧肌,,髌骨及软骨,,缝匠肌,,半膜肌,,股薄肌及肌腱,,半腱肌及肌腱,,,,腘动、静脉,,股二头肌,,髌内侧支持带,,,腓肠肌内侧头肌腱,股外侧肌,Ax-6,,髌外侧支持带,,,髂胫束,股内侧肌,,,缝匠肌,,,,半腱肌及肌腱,,,腘动、静脉,,股二头肌,,髌内侧支持带,,,髌骨及软骨,,腓肠肌内侧头及肌腱,骨薄肌肌腱,半膜肌及肌腱,Ax-7,,髌外侧支持带,,,髂胫束,股内侧肌,,,缝匠肌,,,,半腱肌及肌腱,,股二头肌及肌腱,,髌内侧支持带,,髌骨及软骨,股薄肌肌腱,半膜肌及肌腱,Ax-8,,髌外侧支持带,,髂胫束,,,缝匠肌及肌腱,,,,半腱肌及肌腱,,,髌内侧支持带,,髌骨及软骨,股薄肌肌腱,,髌股关节,股二头肌及肌腱,半膜肌及肌腱,,腓肠肌内侧头 及肌腱,,腓肠肌外侧头,补充 : 同一层面神经血管解剖,,腘动脉,,腘静脉,,胫神经,,腓总神经,,血管搏动伪影,,大隐静脉,,Ax-9,,髂胫束,,缝匠肌及肌腱,,,,半腱肌及肌腱,,,髌内侧支持带,股薄肌肌腱,股二头肌及肌腱,半膜肌腱,,腓肠肌内侧头及肌腱,,腓肠肌外侧头,,前交叉韧带,,内侧副韧带,,髌外侧支持带,Ax-10,,髂胫束,,缝匠肌及肌腱,,,,半腱肌及肌腱,,,髌内侧支持带,股薄肌肌腱,股二头肌及肌腱,半膜肌腱,,腓肠肌内侧头及肌腱,,腓肠肌外侧头,,前交叉韧带,,内侧副韧带,,软骨,Ax-11,,髂胫束,,缝匠肌及肌腱,,,,半腱肌及肌腱,,,髌内侧支持带,股薄肌肌腱,股二头肌及肌腱,半膜肌腱,,腓肠肌内侧头及肌腱,,腓肠肌外侧头,,前交叉韧带,,内侧副韧带,,髌韧带,,股骨外侧髁,,股骨内侧髁,,后交叉韧带,Ax-12,,髂胫束,,缝匠肌及肌腱,,,,半腱肌及肌腱,,,髌下脂肪垫,股薄肌肌腱,股二头肌及肌腱,半膜肌腱,,腓肠肌内侧头,,腓肠肌外侧头,,前交叉韧带,,内侧副韧带,,后交叉韧带,,股骨外侧髁,,股骨内侧髁,,髌韧带,,外侧副韧带,Ax-13,,髂胫束,,,,半腱肌及肌腱,,,髌下脂肪垫,股薄肌肌腱,股二头肌肌腱,半膜肌腱,,腓肠肌内外侧头,,,前交叉韧带,,内侧副韧带,,髌韧带,,外侧副韧带,,后交叉韧带,,腘斜韧带及后关节囊,,髌内侧支持带,Ax-14,,髂胫束,,,,半腱肌肌腱,,,髌下脂肪垫,股薄肌肌腱,股二头肌肌腱,半膜肌肌腱,,腓肠肌内外侧头,,,外侧半月板,,内侧副韧带,,髌韧带,,外侧副韧带,,后交叉韧带,,腘斜韧带及后关节囊,,内侧半月板,,胫骨髁间隆起,,腘肌腱,Ax-15,,髂胫束,,,,半腱肌及肌腱,,,髌下脂肪垫,股薄肌肌腱,股二头肌肌腱,半膜肌腱,,腓肠肌内外侧头,,,胫骨外侧髁,,内侧副韧带,,髌韧带,,外侧副韧带,,后交叉韧带,,胫骨内侧髁,,跖肌,Ax-17,,髂胫束,,,,,股薄肌肌腱,股二头肌肌腱,半膜肌肌腱,,,,胫骨外侧髁,,内侧副韧带,,髌韧带,,外侧副韧带,,腘肌及肌腱,,跖肌,腓肠肌内外侧头,半腱肌肌腱,,胫骨,Ax-18,,股二头肌腱,,腓肠肌外侧头,,跖肌,,腓肠肌内侧头,,腘肌和肌腱,,半腱肌肌腱,,髌韧带,,内侧副韧带,,腓骨头,,Ax-19,,缝匠肌肌腱,,胫前肌,,趾长伸肌和腓骨长肌,,,腓肠肌外侧头,,腓肠肌内侧头,,跖肌,,腘肌,,髌韧带,,Ax-20,,腓骨近端,,大隐静脉,,胫骨前肌,,腘动脉,,,腓肠肌内侧头,腓肠肌外侧头,,趾长伸肌和腓骨长肌,,腘肌,,髌韧带,,胫骨粗隆,,,比目鱼肌,,股薄肌肌腱,,半腱肌肌腱,半月板损伤,,半月板损伤的分级,Ⅰ级损伤 半月板内有灶性点状高信号，但不与半月板的关节面相接触。
这是由于半月板内蛋白多糖沉积过多，出现粘液样变性所致 Ⅱ级损伤 半月板内的线状高信号延伸至半月板关节缘，但未达到半月板关节面 Ⅲ级损伤 半月板内的线状高信号延伸至半月板关节面半月板Ⅰ级损伤,半月板Ⅱ级损伤,Ⅲ级损伤,纵向撕裂、水平撕裂、垂直撕裂、桶柄样撕裂、横向撕裂、水平样撕裂等谢谢！,。