Cerezal L, García-Valtuille R, Canga A, Rolón A, Abascal F
Instituto Radiológico Cántabro, Clínica Mompía, Santander, España.
Radiologia. 2006 Nov-Dec;48(6):341-56. doi: 10.1016/s0033-8338(06)75150-5.
Magnetic resonance (MR) is the most effective imaging technique in the diagnosis of articular pathology. MR arthrography (MRA), with intra-articular injection of diluted gadolinium or physiological saline solution has become more common in recent years. The intra-articular fluid facilitates the detection of articular pathology by delineating the articular structures, separating adjacent anatomic structures, and filling potential spaces that originate in or communicate with the joint. MRA provides additional information about the integrity of the articular structures, especially cartilage, fibrocartilage, and ligaments. MRA has proven especially useful in the shoulder, where most of the studies have been centered. The detection of subtle lesions of the capsule/labrum complex is fundamental for presurgical evaluation. MRA can be used to complement conventional MR imaging in some cases and in others it is the initial technique of choice. Indirect MRA with intravenous gadolinium administration is based on the enhancement of articular fluid caused by diffusion from the synovial space to the articular space. This technique offers better results in articulations with less capacity for distension, such as the wrist, ankle, hand, and foot. This first part of two-part article reviews the current role of MRA in the upper limb. Special emphasis is placed on the shoulder joint, where its usefulness has been most clearly established. The usefulness of this technique in other joints is also described, reviewing the most important anatomic aspects, techniques and applications.
磁共振成像（MR）是诊断关节疾病最有效的成像技术。近年来，关节内注射稀释钆或生理盐水溶液的磁共振关节造影（MRA）已变得更为常见。关节内液体通过勾勒关节结构、分离相邻解剖结构以及填充起源于关节或与关节相通的潜在间隙，有助于检测关节疾病。MRA可提供有关关节结构完整性的额外信息，尤其是软骨、纤维软骨和韧带。MRA已被证明在肩部特别有用，大多数研究都集中在肩部。检测关节囊/盂唇复合体的细微病变对于术前评估至关重要。在某些情况下，MRA可用于补充传统MR成像，而在其他情况下，它是首选的初始技术。静脉注射钆的间接MRA基于从滑膜间隙扩散到关节间隙引起的关节液强化。这种技术在扩张能力较小的关节，如腕关节、踝关节、手部和足部，能提供更好的结果。这篇分两部分的文章的第一部分回顾了MRA在上肢的当前作用。特别强调了肩关节，其效用已得到最明确的证实。还描述了该技术在其他关节的效用，回顾了最重要的解剖学方面、技术和应用。
