Filosto L, Lo Casto A, Sparacia G, Grisanti M, Iovane A, Cardinale A E
Istituto di Radiologia Pietro Cignolini, Università di Palermo.
Radiol Med. 1994 Jul-Aug;88(1-2):8-12.
Magnetic Resonance Imaging (MRI) is a valuable technique to study knee meniscal tears. A series of 330 patients with knee traumas was retrospectively reviewed to systematize the semiologic features of a particular kind of meniscal tear, the "bucket-handle" one. MR investigations were performed with an 0.5-T superconductive magnet, surface coil and spin-echo T1-weighted and gradient-echo (FFE) T2*-weighted sequences on the coronal and the sagittal planes. Twenty-nine patients exhibited bucket-handle tears, 25 of the medial and 4 of the lateral meniscus. In all 29 patients joint effusion was observed; in 18 patients capsulo-ligamentous lesions were associated. MR findings were confirmed by arthroscopy and/or surgery. Semiologic features characterizing the bucket-handle tear on the coronal plane are: truncated triangular shape of the peripheral meniscus and low-intensity band between the posterior cruciate ligament and the tibial plateau, corresponding to the central fragment displaced in the intercondylar notch. In the lateral meniscus, the fragment is found beneath the anterior cruciate ligament. On the sagittal plane this band parallels the posterior or anterior cruciate ligaments, depending on the involved meniscus, with a typical "second cruciate posterior or anterior ligament" or "third cruciate ligament" pattern. The semiology of such findings of bucket-handle meniscal tears is useful in the differential diagnosis with other kinds of meniscal tears.
磁共振成像(MRI)是研究膝关节半月板撕裂的一项重要技术。回顾性分析了330例膝关节创伤患者,以系统化一种特殊类型的半月板撕裂,即“桶柄状”撕裂的症状学特征。使用0.5-T超导磁体、表面线圈以及在冠状面和矢状面上的自旋回波T1加权和梯度回波(FFE)T2 *加权序列进行MR检查。29例患者出现桶柄状撕裂,其中内侧半月板25例,外侧半月板4例。所有29例患者均观察到关节积液;18例患者伴有关节囊韧带损伤。MR检查结果经关节镜检查和/或手术证实。冠状面上桶柄状撕裂的特征性症状学表现为:半月板外周呈截断三角形,后交叉韧带与胫骨平台之间出现低信号带,对应于移位至髁间切迹的中央碎片。在外侧半月板,碎片位于前交叉韧带下方。在矢状面上,根据受累半月板的不同,此低信号带与后交叉韧带或前交叉韧带平行,呈典型的“后或前第二交叉韧带”或“第三交叉韧带”模式。桶柄状半月板撕裂的这些表现的症状学在与其他类型的半月板撕裂的鉴别诊断中很有用。