Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Biceps Femoris Tendon and Lateral Collateral Ligament: Analysis of Insertion Pattern Using MRI

대퇴이두건과 외측 측부인대: 자기공명영상을 이용한 부착형태 유형의 분석

  • Shin, Yun Kyung (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University) ;
  • Ryu, Kyung Nam (Department of Radiology, Kyung Hee University Hospital) ;
  • Park, Ji Seon (Department of Radiology, Kyung Hee University Hospital) ;
  • Lee, Jung Eun (Department of Radiology, Kyung Hee University Hospital) ;
  • Jin, Wook (Department of Radiology, Kyung Hee University Hospital at Gandong) ;
  • Park, So Young (Department of Radiology, Kyung Hee University Hospital at Gandong) ;
  • Yoon, So Hee (Department of Radiology, Kyung Hee University Hospital at Gandong) ;
  • Lee, Kyung Ryeol (Department of Radiology, Jeju National University Hospital)
  • 신윤경 (경희대학교 의과대학 경희의료원 영상의학과) ;
  • 류경남 (경희의료원 영상의학과) ;
  • 박지선 (경희의료원 영상의학과) ;
  • 이정은 (경희의료원 영상의학과) ;
  • 진욱 (강동경희대병원 영상의학과) ;
  • 박소영 (강동경희대병원 영상의학과) ;
  • 윤소희 (강동경희대병원 영상의학과) ;
  • 이경렬 (제주대학교병원 영상의학과)
  • Received : 2014.07.14
  • Accepted : 2014.08.19
  • Published : 2014.09.30
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Abstract

Purpose : The biceps femoris tendon (BFT) and lateral collateral ligament (LCL) in the knee were formerly known to form a conjoined tendon at the fibular attachment site. However, the BFT and LCL are attached into the fibular head in various patterns. We classified insertion patterns of the BFT and LCL using MR imaging, and analyzed whether the LCL attaches to the fibular head or not. Materials and Methods: A total of 494 consecutive knee MRIs of 470 patients taken between July 2012 and December 2012 were retrospectively reviewed. There were 224 males and 246 females, and patient age varied from 10 to 88 (mean, 48.6). The exclusion criteria were previous surgery and poor image quality. Using 3T fat-suppressed proton density-weighted axial images, the fibular insertion patterns of the BFT and LCL were classified into following types: type I (the LCL passes between the anterior arm and direct arm of the BFT's long head), type II (the LCL joins with anterior arm of the long head of the BFT), type III (the BFT and LCL join to form a conjoined tendon), type IV (the LCL passes laterally around the anterior margin of the BFT), and type V (the LCL passes posteriorly to the direct arm of the BFT's long head). Results: Among the 494 cases of the knee MRI, there were 433 (87.65%) type I cases, 21 (4.25%) type II cases, 2 (0.4%) type III cases, 16 (3.23%) type IV cases, and 22 (4.45%) type V cases. There were 26 cases (5.26%) in which the LCL and BFT were not attached into the fibular head. Conclusion: The fibular attachment pattern of the BFT and LCL shows diverse types in MR imaging. The LCL does not adhere to the head in some patients.

목적: 슬관절에서 대퇴이두건과 외측 측부인대는 병합건을 형성하여 비골에 붙는다고 알려져있다. 그러나 대퇴이두건과 외측 측부인대는 여러 형태로 비골두에 붙는다. 우리는 자기공명영상을 이용하여 대퇴이두건과 외측 측부인대의 부착 형태를 분류하였고 외측 측부인대가 비골두에 붙는지 여부를 분석하였다. 대상과 방법: 2012년 7월부터 2012년 12월 사이에 슬관절 자기공명영상을 촬영한 470명의 환자의 총 494개의 자기공명영상을 후향적으로 평가하였다. 224명의 남자, 246명의 여자가 포함되었으며 나이는 10세에서 88세(평균, 48.6세) 범위였다. 배제기준은 이전의 수술을 받거나 영상질이 나쁜 경우였다. 3T 지방억제 수소밀도 강조영상을 이용하여 대퇴이두건과 외측 측부인대의 비골부착 형태를 다음과 같이 분류하였다: 유형 I (외측 측부인대가 대퇴이두건 장골의 전방팔과 직접팔 사이로 지나간다), 유형 II (외측 측부인대가 대퇴이두건 장골의 전방팔과 합쳐진다), 유형 III (대퇴이두건과 외측 측부인대가 병합건을 형성한다), 유형 IV (외측 측부인대가 대퇴이두건의 전방으로 돌아 외측으로 지나간다), 유형 V (외측측부인대가 대퇴이두건 장골의 직접팔의 후방으로 지나간다). 결과: 슬관절 자기공명영상의 494 증례 가운데, 유형 I이 433 (87.65%)예, 유형 II가 21 (4.25%)예, 유형 III이 2 (0.4%)예, 유형 IV가 16 (3.23%)예, 유형 V가 22 (4.45%)예 였다. 대퇴이두건과 외측 측부인대가 비골두에 붙지않는 경우는 26 (5.26%)예 였다. 결론: 대퇴이두건과 외측 측부인대의 비골두 부착은 자기공명영상에서 다양한 형태를보인다. 외측 측부인대는 어떤 환자에서는 비골두에 부착하지 않는다.

Keywords

References

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