半月板前角伪撕裂征。
Pseudotear Sign of the Anterior Horn of the Meniscus.
机构信息
Department of Orthopaedics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Pathology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
Arthroscopy. 2021 Feb;37(2):588-597. doi: 10.1016/j.arthro.2020.08.024. Epub 2020 Sep 2.
PURPOSE
To observe the morphology of the transverse geniculate ligament of the knee (TGL) by magnetic resonance imaging (MRI) and to analyze the cause of the pseudotear sign of the anterior horn of the meniscus caused by the TGL.
METHODS
Patients who underwent MRI examination of the knee joint in the orthopaedics department of our hospital from July 2016 to August 2019 were identified. The occurrence rate, length, width, thickness, cross-sectional shape, pattern, appearance, and position relative to the anterior horn of the lateral and medial meniscus and anatomical variations were observed by multiplane and multisequence MRI. The frequency and cause of the pseudotear sign also were observed.
RESULTS
The data of 101 patients were analyzed. Among them, 60 were male, and 41 were female. The average age was 42.01 (18-75) years. The occurrence rate of the TGL was 67.3% (68/101), the average length was 38.75 ± 3.56 mm, the median coronal diameter was 1.79 ± 0.60 mm, the median sagittal diameter was 1.88 ± 0.35 mm, and the cross-sectional morphology was mostly oval and round. There were 5 types of TGL connection to the anterior horn of the medial meniscus: type 1, located at the front edge; type 2, located at the upper front edge; type 3, located at the upper edge; type 4, located at the back upper edge; and type 5, was located at the back edge of the anterior horn of the medial meniscus. There was only one type of TGL insertion into the anterior horn of the lateral meniscus, located at the anterior superior edge of the anterior horn of the lateral meniscus. There were 4 cases of the pseudotear sign in the anterior horn of the meniscus, 3 in the lateral meniscus and 1 in the medial meniscus. The pseudotear sign of the anterior horn of the meniscus caused by the TGL was observed at a rate of 5.88% (4/68).
CONCLUSIONS
In MRI examination of the knee, the anterior horn of the meniscus sometimes shows a pseudotear sign. According to the shape and route of the TGL on MRI and the direction and position of the pseudotear sign of the anterior horn of the meniscus, true and false tears of the anterior horn of the meniscus can be identified.
LEVEL OF EVIDENCE
Level III, diagnostic study (retrospective, noncomparative, observational case series without a consistently applied reference "gold" standard).
目的
通过磁共振成像（MRI）观察膝关节横突状半月板韧带（TGL）的形态，并分析 TGL 引起半月板前角假性撕裂征的原因。
方法
回顾性分析 2016 年 7 月至 2019 年 8 月我院骨科行膝关节 MRI 检查的患者。多平面、多序列 MRI 观察 TGL 的发生率、长度、宽度、厚度、横截面积形状、类型、模式、外观以及相对于外侧和内侧半月板前角的位置和解剖变异，并观察假性撕裂征的出现频率和原因。
结果
共分析 101 例患者，其中男 60 例，女 41 例，平均年龄 42.01（18-75）岁。TGL 发生率为 67.3%（68/101），平均长度为 38.75±3.56mm，冠状面中位数直径为 1.79±0.60mm，矢状面中位数直径为 1.88±0.35mm，横截面积多为椭圆形和圆形。TGL 与内侧半月板前角的连接有 5 种类型：1 型，位于前缘；2 型，位于前上缘；3 型，位于上缘；4 型，位于后上缘；5 型，位于内侧半月板前角的后缘。外侧半月板前角只有 1 种 TGL 插入类型，位于外侧半月板前角前上缘。内侧和外侧半月板前角各有 1 例假性撕裂征，共 4 例，外侧半月板前角 3 例，内侧半月板前角 1 例。TGL 引起的半月板前角假性撕裂征发生率为 5.88%（4/68）。
结论
在膝关节 MRI 检查中，半月板前角有时会出现假性撕裂征。根据 MRI 上 TGL 的形状和路径以及半月板前角假性撕裂征的方向和位置，可以鉴别半月板前角的真性和假性撕裂。
证据水平
III 级，诊断研究（回顾性、非对照、观察性病例系列研究，无一致应用的参考“金标准”）。
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