Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/24549828
http://link.springer.com/article/10.1007%2Fs00256-014-1830-9
http://www.anatomia-fisioterapia.es/es/es/component/content/article/28-articles/systems/musculoskeletal/lower-extremity/knee/1045-las-inserciones-distales-del-tendon-del-semimembranoso
De:
De Maeseneer M1, Shahabpour M, Lenchik L, Milants A, De Ridder F, De Mey J, Cattrysse E.
Skeletal Radiol. 2014 Jun;43(6):781-91. doi: 10.1007/s00256-014-1830-9. Epub 2014 Feb 19.
Todos los derechos reservados para:
© Springer International Publishing AG, Part of Springer Science+Business Media
Abstract
OBJECTIVE:
The purpose of this study is to investigate the distal insertions of the semimembranosus tendon with MR imaging, correlated with findings in cadavers.
MATERIALS AND METHODS:
Four fresh cadaveric specimens were studied with 3-T MR imaging. Sequences included proton density (PD) sequences (TE, 13; TR, 4957; FOV, 170 × 170; matrix, 424 × 413; NA, 2; slice thickness, 2.5 mm) in the axial, coronal, and sagittal planes and 3D fast field echo (FFE) sequences (TR 9.4; TE 6.9; FOV, 159 × 105; matrix, 200 × 211; NA, 2; slice thickness, 0.57 mm). One specimen was dissected and three specimens were sectioned with a bandsaw in the axial, coronal, and sagittal plane. The sections were photographed and correlated with MR images. To standardize the analysis, the semimembranosus muscle and tendon were assessed at seven levels for the axial sections, and at three levels for the coronal and sagittal sections.
RESULTS:
Anatomic dissection revealed six insertions of the distal semimembranosus tendon: direct arm, anterior arm, posterior oblique ligament extension, oblique popliteal ligament extension, distal tibial expansion (popliteus aponeurosis), and meniscal arm. Axial MR images showed five of six insertions: direct arm, anterior arm, oblique popliteal ligament extension, posterior oblique ligament extension, and distal tibial expansion. SagittalMR images showed four of six insertions: direct arm, anterior arm, oblique popliteal ligament arm, and distal tibial expansion. Sagittal MR images were ideal for showing the direct arm insertion, but were less optimal than the axial images for showing the other insertions. The anterior arm was seen but volume averaging was present with the gracilis tendon. Coronal MR images optimally revealed the anterior arm, although magic angle artifact was present at its posterior aspect. The common semimembranosus tendon and meniscal arm were also well depicted. The division in anterior arm, direct arm, and oblique popliteal ligament arm was poorly seen on coronal images due to volume averaging.
CONCLUSIONS:
Although the anatomy of the distal semimembranosus tendon is complex, six different semimembranosus insertions can be identified on routine proton density and FFE sequences at 3 T. Analysis of images at defined levels in the three imaging planes simplifies MRinterpretation of the anatomy of the distal semimembranosus tendon.
- PMID:
- 24549828
- [PubMed - indexed for MEDLINE]
Las inserciones distales del tendón del semimembranoso
El tendón distal del semimembranoso (SM) es un componente importante del complejo posteromedial. La anatomía del tendón distal del SM es bastante compleja y se han descrito varias inserciones. El propósito de este estudio fue investigar la anatomía de imagen de las diferentes inserciones del tendón distal del SM.
Hablamos en general de seis diferentes inserciones del tendón del SM. 1) la inserción directa; desde el tendón común del SM a la cara posterior de la tibia 1cm por debajo de la articulación. 2) inserción anterior; desde el tendón común del SM desciende posteromedial a la tibia, inserta profundamente al ligamento colateral medial. 3) inserción del ligamento poplíteo oblicuo; desde el tendón común del SM al ligamento poplíteo oblicuo. 4) inserción del ligamento oblicuo posterior; la vaina pasa sobre el tendón del SM a nivel del espacio articular en dirección al ligamento oblicuo posterior. 5) inserción meniscal; desde el SM al ligamento coronario del cuerno posterior del menisco interno. 6) inserción distal; desde la parte distal el tendón del SM al músculo poplíteo.
Las conclusiones del autor dan una idea de la compleja anatomía de imagen del tendón distal del semimembranoso. Se pueden visualizar bien seis inserciones distales del tendón del semimembranoso cuando se combinan los hallazgos de imagen en los tres planos de imagen. Kiné Care (
www.msk-ultrasound.com) anima a todos a estudiar este artículo en detalle, ya que contiene gran cantidad de información que podría ser útil para la práctica clínica.
