27-year-old man with knee injury

回答

Meniscofemoral ligament (MFL)

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Key words: 膝、膝関節、正常構造、ピットフォール、後十字靭帯、半月大腿靭帯、前半月大腿靭帯、後半月大腿靭帯、ハンフリー靭帯リズバーグ靭帯、knee, knee joint, normal anatomy, pitfall, posterior cruciate ligament, meniscofemoral ligament, anterior meniscofemoral ligament, posterior meniscofemoral ligament, Humphrey’s ligament, Wrisberg’s ligament, Humphrey, Humphry, Wrisberg

Key images: Wrisberg’s ligament  27-year-old man with knee injury.

Wrisberg 靭帯、27歳男性 問題提示症例

MFL シェーマ Proton WI sagittal 矢印付Proton WI coronal 矢印付

Humphrey’s ligament case 82-year-old woman

ハンフリー靭帯 82才女性例

82才女性例別症例 Humphrey's lig.

Reference 文献:

1. Bintoudi A1, Natsis K, Tsitouridis I.

Anterior and posterior meniscofemoral ligaments: MRI evaluation.

Anat Res Int. 2012;2012:839724. Epub2012 Sep 17.

  • Wrisberg ligament (PCLの後側), pMFL

–500例中322例 64.4%≒64%

      男性240(75%), 女性 82例(25%),  冠状断で描出されやすい

  • Humphrey ligament (PCLの前側), aMFL

–500例中59例 11.8%≒12%,

男性40(68%), 女性 19例(32%), 矢状断で描出されやすい

2.Watanabe AT, Carter BC, Teitelbaum GP, Bradley WG Jr.

Common pitfalls in magnetic resonance imaging of the knee.

J Bone Joint Surg Am. 1989 Jul;71(6):857-62.

 

3.  Kim JE, Choi SH

Is the location of the Wrisberg ligament related to frequent complete discoid lateral meniscus tear?

Acta Radiol. 2010 Dec; 51:1120-5. doi: 10.3109/02841851.2010.520026.

 

4. De Abreu MR, Chung CB, Trudell D, etal.

Meniscofemoral ligaments: patterns of tears and pseudotears of the menisci using cadaveric and clinical material.

Skeletal Radiol. 2007;36:729-735. Epub 2007 May 5.

 

5. Park LS, Jacobson JA, Jamadar DA, et al.

Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear:MRI findings.

Skeletal Radiol. 2007; 36:399-403. Epub 2007 Jan 16

 

6. Erbagci H, Yildirim H, Kizilkan N, Gümüsburun E.

An MRI study of the meniscofemoral and transverse ligaments of the knee.

Surg Radiol Anat. 2002 May;24(2):120-4.

 

 

Degenerated large adrenal tumor, 60-year-old woman

解答編

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Key words: 副腎癌、副腎腺腫、巨大変性副腎腺腫、Adrenocortical carcinoma, ACC, large degenerated adrenocortical adenoma, pheochromocytoma

 

Key images.

CT

Plain CT(単純CT)

Plain CT1Dynamic CT early phase (ダイナミック造影CT 早期相)Poral phase1

Dynamic CT delayed phase (ダイナミック造影CT後期相)Delayed phase1Dynamic CT delayed phase (ダイナミック造影CT後期相): coronal (冠状断)

Delayed phase1 coronal

MRI

T2WIT2WI 1T1WI  with opposed phaseT1WI Opposed phase 1coronalDynamic MRI early phase   Dynamic early phase 1Dynamic MRI portal phase

Dynamic portal phaese 1Dynamic MRI delayed phase, coronal

Dynamic delayed phase 1 coronal

Diffusion weighted imageDWI 1