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[腕关节的磁共振成像]

[MRI of the wrist joint].

作者信息

Shahabpour M, Lacotte B, David P, Roth D, Osteaux M

机构信息

Hôpital Universitaire de la Vrije Universiteit Brussel (VUB), Belgique.

出版信息

Ann Radiol (Paris). 1992;35(5):341-8.

PMID:1288400
Abstract

Due to the development of new surface coils and the use of thin slices, MRI has become an essential diagnostic tool in wrist pathology. After several technical considerations, the authors describe the normal MRI appearance of the various anatomical structures of the wrist, particularly the triangular fibrocartilaginous complex of the wrist and the elements of the carpal tunnel. They review the principal indications for MRI: chronic diseases such as carpal tunnel syndrome and traumatic ligamentous and cartilaginous lesions. The bone marrow lesions detected in the presence of occult fractures and osteonecrosis of the lunate or scaphoid are then briefly considered. The diagnostic criteria of median nerve compression (carpal tunnel syndrome) include morphological and signal changes in the nerve, abnormal palmar convexity of the flexor retinaculum and signs of tenosynovitis of the intracarpal flexor tendons. However, in practice, MRI is only useful when there is disagreement between the clinical and EMG findings and in postoperative recurrences, in which case it may reveal insufficient section of the retinaculum or the presence of exuberant postoperative fibrosis responsible for persistent nerve compression. Traumatic tears of the triangular fibrocartilage are characterised by a linear high signal intensity image (on T1 and T2 weighted sequences), usually situated in the periphery of the articular disk. Degenerative lesions tend to be central, within the disk and are frequently observed after the age of 40 years.

摘要

由于新型表面线圈的发展以及薄层扫描的应用,磁共振成像(MRI)已成为腕部疾病重要的诊断工具。在经过多项技术考量后,作者描述了腕部各种解剖结构的正常MRI表现,尤其是腕部三角纤维软骨复合体及腕管内的结构。他们回顾了MRI的主要适应证:如腕管综合征等慢性疾病以及创伤性韧带和软骨损伤。随后简要探讨了在隐匿性骨折以及月骨或舟骨缺血性坏死时所检测到的骨髓病变。正中神经受压(腕管综合征)的诊断标准包括神经的形态和信号改变、屈肌支持带掌侧异常凸起以及腕内屈肌腱腱鞘炎的征象。然而,在实际应用中,只有当临床和肌电图检查结果不一致以及术后复发时,MRI才有用,此时它可能显示支持带切开不充分或存在导致神经持续受压的术后过度纤维化。三角纤维软骨的创伤性撕裂表现为线性高信号影像(在T1加权和T2加权序列上),通常位于关节盘周边。退行性病变往往位于关节盘中央,40岁以后较为常见。

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