Tardieu M, Lazennec J Y, Christel P, Brasseur J L, Roger B, Grenier P
Service de Radiologie Centrale, Hôpital de la Salpétrière, Paris.
J Radiol. 1995 Sep;76(9):605-9.
The purpose of the study is to compare normal PLC anatomy and its MRI appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit with gradient echo T1, T1 and T1 GD-DOTA IV. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilisation of lateral condyle. Unrecognised and untreated posterolateral instability may result in failure of ACL reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC.
本研究的目的是比较正常腘肌腱复合体(PLC)的解剖结构及其MRI表现,以及在MRI中观察到的各种病变,从单纯的腘肌腱挫伤至完全的PLC断裂。针对PLC损伤的这项具体研究,我们从过去3年中接受检查的创伤性膝关节病例中选取了61例进行研究。对这61例患者均进行了手术相关性分析。MRI检查在一台0.5T设备上进行,采用梯度回波T1、T1及T1 GD-DOTA IV序列。将正常PLC的解剖结构与4例解剖标本的解剖结果进行比较。利用该参考分析对正常MRI切片进行评估。PLC的主要解剖结构包括外侧副韧带、腘肌腱、弓状韧带、腓肠豆腓侧韧带、后外侧髁关节囊以及外侧半月板后角。手术结果证实58例患者存在PLC损伤,3例假阳性。对这些损伤进行诊断很重要,因为慢性后外侧松弛继发于外侧髁的失稳。未被识别和未治疗的后外侧不稳定可能导致前交叉韧带重建失败。当临床检查结果存疑或复杂,或者检查非常疼痛时,MRI可对创伤性膝关节,尤其是PLC进行全面评估。