前交叉韧带重建后正常移植物及并发症的磁共振影像表现
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R445.2

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国家自然科学基金(81701652)


Magnetic resonance imaging of normal grafts and complications after anterior cruciate ligament reconstruction
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    摘要:

    目的:回顾前交叉韧带重建术后正常移植物不同时期的信号特点及并发症的磁共振成像(magnetic resonance imag- ing,MRI)表现。方法:回顾分析2012年1月—2023年3月在南京医科大学第一附属医院因前交叉韧带重建复查而行MRI检查的299例患者的影像学资料,根据移植物并发症在MRI上的不同表现进行分类,描述其在T1WI和T2WI上的信号表现,并与其临床症状相结合。结果:在299例患者中,手术后4~6个月T2WI上移植物信号最高。66例(22.07%)出现了移植后并发症,包括5例(1.67%)胫骨隧道前移,1例(0.33%)胫骨隧道位置稍偏后。16例(5.35%)出现Cyclops病变,10例(3.34%)发生移植物的再次断裂,1例(0.33%)出现术后感染。33例(11.04%)在术后不同时间出现移植物隧道内囊性灶。在胫骨隧道前移的患者中有2例同时出现了移植物的再次断裂和Cyclops病变。结论:MRI作为前交叉韧带重建患者术后复查的一种主要方式,发挥重要作用,它能清晰反映移植物在不同阶段的变化及并发症表现,有早发现早提示的作用,以便临床医生早期采取干预措施,提高患者术后的生活质量。

    Abstract:

    Objective:This study aims to review the magnetic resonance imaging(MRI)features of normal grafts at different stages of signal characteristics and complications after anterior cruciate ligament reconstruction(ACLR). Methods:The imaging data of 299 patients who underwent MRI for reexamination after the ACLR at the First Affiliated Hospital of Nanjing Medical University from January 2012 to March 2023 were reviewed,and were classified according to the different manifestations of graft complications on MRI. Their signal on T1WI and T2WI was described and combined with their clinical symptoms. Results:In 299 patients,signal was highest at 4-6 months postoperatively. Post-transplantation complications were observed in 66(22.07%),of which 5(1.67%)had an anterior displacement of the tibial tunnel ,and 1(0.33%)had a slightly posterior position of the tibial tunnel. Cyclops lesion was seen in 16(5.35%),re-rupture of the graft occurred in 10(3.34%),and 1(0.33%)had a postoperative infection. Cystic signal in the tunnel were present in 33(11.04%)at various times postoperatively. There are 2 patients who underlying anterior displacement of the tibial tunnel had both re-rupture and Cyclops lesion of the graft. Conclusion:MRI plays an important role as a major tool for postoperative follow-up of patients after ACLR. It can clearly reflect the changes of the graft at different stages and the manifestation of complications,providing early detection and warning,so that clinicians can take early interventions to improve the quality of life for patients after surgery.

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李雨萍,章宇媚,邹月芬.前交叉韧带重建后正常移植物及并发症的磁共振影像表现[J].南京医科大学学报(自然科学版),2024,(3):387-392

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  • 收稿日期:2023-08-04
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  • 在线发布日期: 2024-03-07
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