Ando Y, Fukatsu H, Ishigaki T, Aoki I, Yamada T
Department of Radiology, Nagoya University School of Medicine, Japan.
Radiat Med. 1994 Jul-Aug;12(4):153-60.
This study was performed to make a normal standard by analyzing normal knee movement in detail. An open low-field unit was used for 23 healthy knee joints. With three-dimensional Fourier transformation (3DFT) gradient echo sequence, 50 sagittal slices of 4.5 mm in thickness were obtained at four flexion angles: 0, 30, 60, and 90 degrees (lateral position). Although the tension ratio of the anterior and posterior cruciate ligaments (ACL, PCL) increased during knee flexion, the change in the tension ratio was significantly different between the ACL and PCL. The femur-ACL angle and femur-PCL angle were parallel with the knee flexion angle, but the tibia-ACL angle and tibia PCL angle changed complexly. The lateral and medial condyles rolled and slid during knee flexion, and the medial side moved more than the lateral side, consistent with rotation of the lower thigh. The difference in backward movement distance on the tibia between the two condyles was significantly larger in females than in males. This might explain the dominance of knee osteoarthritis in women. Although the lateral position is not completely physiological, we could show initial cinematic data of up to 90 degrees of knee flexion using open-type MRI, which is impossible with high- and middle-field machines.
本研究旨在通过详细分析正常膝关节运动来制定一个正常标准。对23个健康膝关节使用开放式低场设备。采用三维傅里叶变换(3DFT)梯度回波序列,在四个屈膝角度(0、30、60和90度,侧位)获取50层厚度为4.5mm的矢状面图像。虽然在膝关节屈曲过程中前交叉韧带(ACL)和后交叉韧带(PCL)的张力比增加,但ACL和PCL的张力比变化存在显著差异。股骨-ACL角和股骨-PCL角与屈膝角度平行,但胫骨-ACL角和胫骨-PCL角变化复杂。在膝关节屈曲过程中外侧髁和内侧髁滚动并滑动,内侧移动幅度大于外侧,与大腿下部的旋转一致。女性两髁在胫骨上向后移动距离的差异明显大于男性。这可能解释了女性膝关节骨关节炎的优势。虽然侧位并非完全符合生理状态,但我们能够使用开放式MRI展示高达90度屈膝的初始运动学数据,这是高场和中场设备无法做到的。