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论著-头颈部

成人胫骨结节损伤的MRI表现*

作者:刘德海 丁长青 王安震 孙惠芳

所属单位:江苏省徐州市丰县人民医院影像科 (江苏 徐州 221700)

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摘要

目的 探讨成人胫骨结节损伤的 MRI表现特征。方法 回顾性分析14例成 人胫骨结节损伤的临床和MRI资料。结 果 急性期损伤10例,均伴髌韧带远侧肥 厚肿胀、信号增高;其中胫骨结节挫伤 及不全撕脱7例,表现为胫骨结节水肿信 号、与骨干分离不明显;胫骨结节完全 撕脱3例,伴髌韧带回缩及骨折片明显游 离;慢性期损伤4例,均伴胫骨结节骨性 突起明显及髌韧带远侧高信号,1例骨碎 片存留在髌韧带内。结论 MRI可清晰显 示成人胫骨结节急慢性损伤的影像学特 征,值得应用。

Objective To investigate the MRI features of tibial tubercle injury in adult. Methods A retrospective analysis of clinical and MRI data of 14 cases with tibial tubercle injury in adult. Results Of all the cases,10 cases were acute phase injury, were associated with swelling, hypertrophy and increased signal in the distal of the patellar ligament.7 cases of the 10 cases were contusion and incomplete avulsion of the tibial tubercle, which showed edema signal and the separation of the backbone was not obvious.3 cases were completely avulsion of tibial tubercle, with patellar tendon retraction and free fracture. 4 cases were chronic injury, associated with obvious bony protrusion in tibial tubercle and high signal in the distal area of the patellar ligament, one case of bone fragments retained in the patellar tendon. Conclusion MRI imaging can clearly show the characteristic of the acute and chronic injury of tibial tubercle in adult,so which is worthy of application.

【关键词】胫骨结节;骨折;前膝痛; 磁共振成像

【中图分类号】R274.1

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.02.039

前言

胫骨结节损伤可分为急性期及慢性期损伤。急性期损伤主要为挫 伤及急性胫骨结节撕脱,后者是一种比较少见的骨折,以13~17岁的 体育运动者多见,罕见于成人。胫骨结节骨折后可造成膝前疼痛、膝 关节反曲、关节屈伸功能障碍、再骨折、筋膜间室综合征等并发症的 发生[1-2]。随着MRI的渐趋普及,其优良的软组织成像能力,对本症的 诊断及鉴别诊断的价值越来越重要。鉴于MRI对本症诊断的国内外文献 报告较少,现收集我院2012年10月~2015年5月14例临床证实的胫骨结 节损伤的资料,旨在探讨MRI的诊断及其鉴别诊断价值。