磁共振成像评价不同材料前交叉韧带重建后移植物完整性:和关节镜再观察的比较  

Integratiy of postoperative anterior cruciate ligament grafts:Evaluation between magnetic resonance image and second arthroscopy findings

作　　者：窦永峰[1] 耿晓鹏[1] 陈百成[2] 高巍[3] 房清敏[1] 孙兆忠[1] 张新军[1] 

机构地区：[1]滨州医学院附属医院骨科,山东省滨州市256603 [2]河北医科大学附属第三医院关节外科,河北省石家庄市050051 [3]解放军305医院骨科,北京市100017

出　　处：《中国组织工程研究与临床康复》2010年第12期2253-2256,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:目前有关MRI评价前交叉韧带重建后移植物完整性的精确性仍存在争议,同时观察健康前交叉韧带移植物关节镜下表现及MRI有关信号强度改变的研究资料较少。目的:对经关节镜检查证实的健康前交叉韧带移植物进行磁共振成像评价,确定其主要表现。方法:对经关节镜下前交叉韧带重建术后效果优良的25例患者进行磁共振成像检查和关节镜再观察,自体骨-髌腱-骨移植14例,四股腘绳肌腱移植11例。对26例次的关节镜结果和28例次的磁共振成像结果进行分析。结果与结论:26例次关节镜再观察中,有22例次(84.6%)滑膜覆盖良好,前交叉韧带移植物张力正常的23例次(88.5%)。随着时间的推移,重建术后健康的前交叉韧带移植物的主要磁共振成像表现为低信号束移植物,合并有纵向的信号增强的条纹状束,保持良好的连续性和紧张有力的走向,前交叉韧带移植物的信号强度基本都表现出逐渐降低的趋势,但差异没有显著性意义(P>0.05)。前交叉韧带移植物矢状位直径均值表现为先减少后增加的趋势,总体上矢状位直径趋于增大,但差异无显著性意义(P>0.05)。BACKGROUND：It remains controversial about the accuracy of MRI evaluation on the graft integrity following anterior cruciate ligament（ACL）reconstruction.There are few data recording manifestations and MRI signal intensity changes of healthy surviving ACL grafts at different stages.OBJECTIVE：To evaluate the postoperative magnetic resonance（MR）findings of healthy ACL grafts confirmed by second arthroscopic examination.METHODS：A total of 25 patients underwent arthroscopic ACL reconstruction and had a good or excellent postoperative result,including 14 cases of autogenous bone-patellar tendon-bone rafts and 11 cases of autogenous double-loop hamstring grafts.A total of 26 second arthroscopy and 28 MRI were analyzed.RESULTS AND CONCLUSION：Among the 26 cases of second arthroscopic examinations,there were 22 cases（84.6%）of good synovialization,and the tension of the ACL grafts was normal in 23 cases（88.5%）.The major postoperative MR findings of the healthy ACL autografts were low graft with longitudinal streak-increased signal intensity bands,well-preserved continuation,and taut orientation.The signal intensity of ACL grafts showed the same tendency of decrease with time after operation,but it was not statistically significant（P 0.05）.The mean value of sagittal diameter of the ACL graft decreased initially,and increased gradually;the sagittal diameter of the ACL graft tended to be thicker with time after reconstruction,but this result was not significant statistically（P 0.05）.

关 键 词：前交叉韧带移植物 膝关节重建术后 磁共振成像 关节镜检查 生物材料 

分 类 号：R318[医药卫生—生物医学工程]