Department of Radiology, University Hospital Zurich, Zurich, Switzerland.
Radiology. 2010 Oct;257(1):185-94. doi: 10.1148/radiol.10092163. Epub 2010 Aug 9.
To prospectively evaluate the normal variability of ligaments, plicae, and the posterior capitellum on conventional magnetic resonance (MR) images of the elbow in asymptomatic volunteers.
The study was approved by the institutional ethics board, and informed consent was obtained from all subjects. MR imaging was performed at 1.5 T in 60 asymptomatic volunteers (30 women, 30 men; age range, 22-51 years; median age, 32.8 years) by using the following five pulse sequences: transverse T1-weighted spin-echo, sagittal T2-weighted fast spin-echo, coronal fast spin-echo short-inversion-time inversion recovery, transverse intermediate-weighted with fat saturation, and coronal three-dimensional water-excitation true fast imaging with steady-state precession. The visibility (completely visible over the entire course, partially visible, or not visible) and signal intensity characteristics (hypointense or hyperintense to muscle, homogeneous signal intensity vs striation) of the elbow ligaments and plicae were evaluated by three independent readers. The presence of pseudodefects at the posterior capitellum was determined. The dimensions of all structures were measured by two independent readers.
The anterior ulnar collateral ligament (UCL) and radial collateral ligament (RCL) were visible over their entire course in all 60 subjects (100%). The posterior UCL, lateral UCL, and annular ligament (AL) were completely visible in 58 (97%), 51 (85%), and 59 (98%) of the 60 subjects, respectively, and partially visible in the remaining subjects. Increased signal intensity with fluid-sensitive sequences was found in the anterior UCL in nine of the 60 subjects (15%), posterior UCL in four subjects (7%), RCL in one subject (2%), lateral UCL in six subjects (10%), and AL in one subject (2%). The median thickness and 90th percentile were 2.5 and 3.5 mm, respectively, for the anterior UCL, 1.0 and 1.7 mm for the posterior UCL, 1.9 and 2.8 mm for the RCL, 2.3 and 3.8 mm for the lateral UCL, and 1.0 and 1.3 mm for the AL. A posterolateral plica (median dimension, 4.3 × 1.9 × 3.9 mm) was found in 59 of the 60 subjects (98%), whereas a posterior plica (median dimension, 1.8 × 1.4 mm) could be detected in only 20 (33%). A pseudodefect of the capitellum was noted in 51 of the 60 subjects (85%).
The elbow ligaments and the posterolateral plica are consistently visible on conventional MR images of asymptomatic subjects. Most normal ligaments are thinner than 4 mm, and most plicae are thinner than 3 mm.
前瞻性评估无症状志愿者肘部常规磁共振成像（MR）图像中韧带、皱襞和后肱骨小头的正常变异。
本研究经机构伦理委员会批准，并获得所有受试者的知情同意。60 名无症状志愿者（30 名女性，30 名男性；年龄 22-51 岁；中位年龄 32.8 岁）在 1.5T 磁共振扫描仪上进行检查，使用以下 5 种脉冲序列：横轴位 T1 加权自旋回波、矢状位 T2 加权快速自旋回波、冠状位快速自旋回波短反转时间反转恢复、横轴位中权重脂肪饱和和冠状位三维水激发稳态进动真实快速成像。三位独立的读者评估了肘部韧带和皱襞的可见性（全程完全可见、部分可见或不可见）和信号强度特征（与肌肉相比呈低信号或高信号，均匀信号强度与条纹）。确定后肱骨小头是否存在假性缺陷。两位独立的读者测量了所有结构的尺寸。
在 60 名受试者中，前尺侧副韧带（UCL）和桡侧副韧带（RCL）在全程均完全可见（100%）。58 名（97%）、51 名（85%）和 59 名（98%）受试者的后 UCL、外侧 UCL 和环状韧带（AL）完全可见，其余受试者部分可见。在 60 名受试者中的 9 名（15%）出现前 UCL 液体敏感序列信号强度增加，4 名（7%）出现后 UCL、1 名（2%）出现 RCL、6 名（10%）出现外侧 UCL 和 1 名（2%）出现 AL。前 UCL 的平均厚度和第 90 百分位数分别为 2.5mm 和 3.5mm，后 UCL 为 1.0mm 和 1.7mm，RCL 为 1.9mm 和 2.8mm，外侧 UCL 为 2.3mm 和 3.8mm，AL 为 1.0mm 和 1.3mm。59 名（98%）受试者发现后外侧皱襞（平均尺寸，4.3×1.9×3.9mm），而仅 20 名（33%）受试者可检测到后皱襞（平均尺寸，1.8×1.4mm）。51 名（85%）受试者的肱骨小头出现假性缺陷。
在无症状受试者的常规肘部 MR 图像上，肘韧带和后外侧皱襞始终可见。大多数正常韧带厚度小于 4mm，大多数皱襞厚度小于 3mm。
