Cerezal L, Abascal F, Canga A, García-Valtuille R, Rolón A
Instituto Radiológico Cántabro, Clínica Mompía,. Santander, España.
Radiologia. 2006 Nov-Dec;48(6):357-68. doi: 10.1016/s0033-8338(06)75151-7.
Magnetic resonance (MR) is the imaging technique of election in the evaluation of the articular pathology. MR arthrography (MRA) consists of the direct punction of the joint with intraarticular injection of diluted gadolinium or saline solution. MRA produces distention of the capsular recess, delineates the intraarticular structures and separates annexed structures of difficult evaluation, with which it is able to improve the reliability diagnoses of the articular and periarticular pathology. MRA allows to solve some of the diagnostic problems of conventional MR imaging in the evaluation of the articular pathology, avoiding to make unnecessary diagnostic arthroscopy and allowing a better therapeutic plan. In the greater joints of the inferior extremity (hip, knee and ankle) MRA has established indications standing out the evaluation of the injuries of the acetabular labrum of the hip, the operated meniscus of the knee and the study of the "impingement" syndromes of the ankle. This article reviews the present utility of the MRA in the hip, knee and ankle joints. The more relevant anatomical aspects, the technique and the applications are reviewed. Finally, the value of this technique in pathologies that can affect any joint of the organism such as osteochondral injuries, loose intraarticular bodies and synovial pathology is reviewed.
磁共振成像（MR）是评估关节疾病时首选的成像技术。磁共振关节造影（MRA）是将稀释的钆或盐溶液关节内注射后直接穿刺关节。MRA可使关节囊隐窝扩张，勾勒出关节内结构，并分离难以评估的附属结构，从而提高关节及关节周围疾病诊断的可靠性。MRA有助于解决传统MR成像在评估关节疾病时的一些诊断问题，避免不必要的诊断性关节镜检查，并有助于制定更好的治疗方案。在下肢的大关节（髋、膝和踝关节）中，MRA有明确的适应证，尤其突出的是对髋关节髋臼唇损伤、膝关节半月板手术以及踝关节“撞击”综合征的评估。本文综述了MRA在髋、膝和踝关节中的当前应用。回顾了更相关的解剖学方面、技术及应用。最后，综述了该技术在可影响机体任何关节的疾病中的价值，如骨软骨损伤、关节内游离体和滑膜疾病。
