动态磁共振对髌股关节排列的定量评价  

Quantitative Assessment of the Patellofemoral Alignment Using Dynamic MRI

作　　者：王淑丽[1] 蔡跃增[1] 王林森[2] 张晓光[2] 贾楠[1] 

机构地区：[1]天津医科大学总医院放射科,300052 [2]天津市天津医院放射科,300211

出　　处：《临床放射学杂志》2008年第12期1716-1721,共6页Journal of Clinical Radiology

摘　　要：目的探讨动态磁共振成像技术定量评价髌股关节排列的方法和价值。资料与方法选取健康男、女志愿者各15名(30侧膝关节)为正常对照组。随机选取14例(28侧膝关节,男性6例,女性8例)髌股关节排列异常者为疾病组,将既往有外伤史的膝关节作为患侧膝关节组(14侧),而对侧膝关节为无症状组(14侧)。应用特殊位置装置使膝关节从伸直位0°至屈曲位45°范围(间隔5°)内被动运动,应用三维快速梯度回波序列T1WI获取膝关节不同屈曲角度的轴位图像,分别测量髁间沟角(SA)、髌骨倾斜角(PTA)、髌骨移动率(BSO)。分析男、女正常组膝关节在不同屈曲角度各测值侧别及性别间有否差异,并确定上述各测值的参考范围。分析疾病组膝关节不同屈曲角度患膝的各测值与正常组及自身对侧膝关节各测值间有否差异。结果男、女正常两侧膝关节的SA、PTA、BSO值在膝关节不同屈曲角度间差异均无统计学意义。膝关节不同屈曲角度不同性别间统计学分析显示男、女性别间各测值轻微差异。疾病组与正常对照组的SA、PTA、BSO值在膝关节不同屈曲角度差异有统计学意义;疾病组患侧与对侧的SA、PTA、BSO在膝关节各个屈曲角度间差异均无统计学意义。结论双侧髌股关节间存在着相似的结构特征及运动规律;动态MRI不仅能反映髌股关节的异常排列程度,还可以提供异常程度的动态变化趋势,在定量评价髌股关节病变中有重要参考价值。Objective ＇To develope the value of the dynamic MRI in the quantitative assessment of the patellofemoral aligument. Materials and Methods 30 healthy volunteers （total 60 knees, 15 male and 15 female respectively） regarded as healthy control group. 14 patients （total 28 knees,6 males and 8 females） with the affected sides of knees were the disorder group（ 14 knees ） and the opposite side of knees was asymptomatic group （ 14 knees）. Imaging was performed with open MR system using FE3D sequence. The special positioning device permitted the knees acted passively from flexion 0 degree to 45 degrees（ with a interval of 5 degrees）. The patellofemoral alignment was evaluated by measuring the following parameters ： sulcus angle （ SA ） , patellar tilt angle （ PTA ） , bisect offset （ BSO ） on axial image during knee flexion from 0 degree to 45 degrees. The results of bilateral knees and gender differences were statistical analyzed. The parameters of disor- der group were compared with that of control and asymptomatic group in different angles of passive action. Results The SA, PTA, BSO had no significantly different between the two sides of knees in the healthy female and male group respectively. Then the mean values were acquired in SA, PTA, BSO of the knees. The results demonstrated slight statistical differences in BSO, SA and PTA. There were differences in SA, PTA and BSO between the disorder group and the control group at some angles of knee flexion There were no significant differences in SA, PTA, BSO between the disorder group and the asymptomatic group. Conclusion 1. There are similar motion regularity and constructional characteristic in bilateral knees, no matter in healthy control groups or disorder groups. These findings indicated that to evaluate the disorder knee joint, it is not appropriated to regard the opposite joint as control group. 2. Dynamic MRI can provide not only the extent of the patellofemoral malalignment, but also the tendency of the malalignment. Dynamic MRI

关 键 词：动态磁共振 髌股关节排列 定量评价 

分 类 号：R445.2[医药卫生—影像医学与核医学]