<본문 미리보기>

제 01 장 무릎의 해부

1-1 시상면 영상·····················································································2

1-2 관상면 영상····················································································8

1-3 횡단면(축상면) 영상······································································11

제 02 장 MRI 촬영법

2-1 무릎 고정 방법 : 코일 내에서 무릎 경도 굴곡································16

2-2 시상면 영상 설정············································································18

2-3 T1 강조와 fast spin echo법을 이용한 양성자 강조영상···············21

2-4 Magic angle effect········································································23

2-5 In-phase법, out-of-phase법························································25

2-6 횡단면(축상면) 영상의 유용성·······················································26

2-7 ACL에 따른 사상 관상면 영상·······················································26

2-8 지방억제법······················································································28

2-9 금속 아티팩트 정보·········································································29

2-10 연골의 촬영 방법···········································································31

제 03 장 전방십자인대

3-1 해부··································································································42

3-2 정상 전방십자인대의 MRI 소견······················································44

3-3 전방십자인대 파열의 특징·······························································45

3-4 전방십자인대 완전 파열··································································45

3-5 진단이 어려운 전방십자인대 부분 파열··········································48

3-6 전방십자인대 급성 파열···································································50

3-7 전방십자인대 급성 파열과 관련된 파열편에 의한 신전장애···········52

3-8 전방십자인대 만성 파열··································································54

3-9 전방십자인대의 변성·······································································57

3-10 전방십자인대 파열의 2차적 소견··················································60

3-11 경골 과간융기 골절·········································································63

3-12 전방십자인대 재건술······································································66

3-13 재건 인대의 MRI 소견····································································68

3-14 재건 인대의 재파열과 합병증·························································71

3-15 슬개하지방체의 관절경 후 변화······················································77

3-16 파열된 전방십자인대의 보존적 치료················································79

제 04 장 후방십자인대

4-1 해부····································································································84

4-2 후방십자인대 파열···········································································86

4-3 후방십자인대 파열의 MRI 소견·······················································87

제 05 장 내측측부인대를 포함한 내측지지조직

5-1 해부···································································································100

5-2 내측측부인대 파열············································································102

5-3 거위발과 거위발 점액낭염, 무릎 내측의 점액낭·····························108

5-4 반막양근건·······················································································112

5-5 Stieda 음영(Pellegrini-Stieda병)····················································115

제 06 장 외측측부인대를 포함한 외측지지조직

6-1 해부··································································································118

6-2 외측측부인대 파열··········································································124

6-3 비골두 견열 골절과 대퇴이두근 손상·············································128

6-4 Segond 골절··················································································130

6-5 Gerdy 결절의 견열 골절································································133

6-6 장경인대염······················································································134

6-7 장경인대 점액낭과 무릎 외측의 점액낭·········································137

6-8 슬와근건 손상·················································································139

제 07 장 반월상연골

7-1 해부····································································································142

7-2 내측반월상연골과 외측반월상연골····················································143

7-3 반월상연골의 MRI 영상·····································································144

7-4 반월상연골 파열················································································146

7-5 버킷핸들 파열····················································································157

7-6 고령자의 반월상연골 병변·································································162

7-7 반월상연골 변연부 파열과 반월상연골 관절낭의 분리·······················164

7-8 원판형 반월상연골··············································································167

7-9 반월상연골 석회화/반월상연골 소골/가스 발생·································171

7-10 반월상연골 수술 후 MRI 소견····························································174

7-11 반월상연골 병변의 pitfalls·································································180

제 08 장 골절과 탈구, 근육 손상

8-1 경골 고평부 골절··················································································188

8-2 슬개골 골절·························································································191

8-3 슬개골 탈구(반복성/외상성)·······························································193

8-4 슬개골 탈구에 의한 골연골 손상·······················································197

8-5 슬개골 소매 골절················································································200

8-6 박리성 골연골 손상·············································································201

8-7 외상성 무릎 혈관절증········································································205

8-8 스트레스 골절, 피로 골절··································································206

8-9 골좌상·································································································208

8-10 근건 손상··························································································209

제 09 장 유아 및 청소년의 무릎

9-1 대퇴골 원위 피질골 부정상··································································214

9-2 Femoral condyle irregularity 대퇴골 과부 부정상···························218

9-3 Focal Periphyseal Edema(FOPE) 방골단선부 국한성 골수 부종·····221

9-4 통증성 분열 슬개골·············································································223

9-5 슬개골 배측(골화) 결손········································································226

9-6 Osgood-Schlatter병··········································································228

9-7 Sinding-Larsen-Johansson병···························································231

9-8 슬개건염, 점퍼무릎·············································································233

9-9 Blount병·····························································································238

9-10 선천성 전방십자인대 결손증····························································239

제 10 장 연골 손상과 변성 · 괴사

10-1 연골 손상··························································································242

10-2 퇴행성 관절증··················································································245

10-3 인공 슬관절 치환술···········································································247

10-4 특발성 골괴사, 연골하 취약성 골절·················································248

10-5 골수의 재전환···················································································253

제 11 장 활막 병변과 지방체, 추벽 증후군

11-1 류마티스 관절염···············································································256

11-2 건활막 거대세포종(색소성 융모 결절성 활막염)·····························260

11-3 활막 골연골종증··············································································263

11-4 활막 혈관종·····················································································265

11-5 수지상 지방종··············································································267

11-6 Hoffa 증후군···············································································269

11-7 아밀로이드 관절증········································································277

11-8 활막 추벽 증후군··········································································279

  11-8A 슬개상 추벽·············································································281

  11-8B 내측 활막 추벽········································································283

  11-8C 슬개하 추벽·············································································286

제 12 장 무릎 내외의 액체 저류강

12-1 관절 내 ganglion·········································································292

12-2 반월상연골 낭종···········································································295

12-3 슬와 낭종(베이커 낭종)··································································300

12-4 후방관절낭··················································································304

12-5 점액낭과 점액낭염········································································307

  12-5A 전슬개 점액낭·········································································307

  12-5B 천슬개하 점액낭······································································309

  12-5C 심슬개하 점액낭······································································310

  12-5D 전경골 점액낭·········································································311

  12-5E Morel-Lavallée lesion·····························································312

  12-5F Prepatellar fibrosis·································································314

12-6 슬관절 주위의 ganglion································································315

찾아보기 317

 이 책은 무릎의 해부학과 MRI 소견에 대해 체계적으로 다루고 있어, 영상의학을 전공하는 분들은 물론이고 실제 환자를 진료하시는 임상 선생님들께도 유용한 정보를 제공할 것으로 기대됩니다. 

이 책은 무릎 MRI 촬영 방법과 주의해야 할 점을 상세하게 설명하며, MRI 시퀀스의 기본 적인 내용을 다루는 것뿐만 아니라, 실제 해부학적 구조와 수술 소견과의 비교를 통해 실무에 도움이 될 수 있는 다양한 사례들을 소개하고 있습니다. 

또한, 카데바와의 비교를 통해 실제 해부학적 구조를 더 잘 이해할 수 있도록 돕고 있으며, 이를 통해 진단과 치료에 대한 방침을 수립하는데 도움을 줄 수 있을 것으로 기대됩니다. 

무릎의 복잡한 해부학적 구조와 관련된 MRI 해부학을 자세히 다루고 있으며, 이를 통해 독 자들이 더 나은 진료 방향을 모색할 수 있을 것이라 믿어 의심치 않습니다. 

다시 한번, 이 책을 통해 무릎 MRI에 대한 이해를 높이시고 실제 임상에서 유용하게 활용 하실 수 있기를 바랍니다. 

<옮긴이 서문>

무릎 질환과 통증을 호소하는 환자분들에게 현재 제가 해드릴 수 있는 검사는 X-ray와 초음파뿐입니다. 다른 부위에서는 이 조합으로 얻을 수 있는 정보가 많지만 무릎에서는 그렇지 못한 것 같습니다.

특히 연골, 반월상연골, 십자인대 등 무릎 관절 안쪽의 구조물은 더욱더 확인이 어렵습니다. 이런 부위의 병변이 의심되는 경우, 저는 근처의 상급병원에 MRI 검사를 의뢰하고 있습니다.

이처럼 MRI는 무릎 질환에서 가장 정확한 진단을 내릴 수 있는 도구입니다. 하지만 그동안 이에 대해 깊이 공부할 기회가 없었습니다. 그러던 중 이 책을 번역하며 다시 한번 무릎의 해

부학과 MRI에 대해 배울 수 있었습니다.

독자분들도 이 책을 통해 무릎 질환과 통증에 대한 진료의 정확도가 향상되길 바랍니다.

번역에 도움을 주신 여러 선생님들과 신흥메드싸이언스 관계자분들께 감사드립니다.