3D-CT在前交叉韧带重建术后评估中的临床价值  

Three-dimensional Computed Tomography in Postoperative Evaluation of the Knees after Anterior Cruciate Ligament Reconstruction

作　　者：戚喜勋[1] 关丽明[1] 郭磊[2] 朱玉森[1] 李松柏[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]中国医科大学附属第一医院骨科,沈阳110001

出　　处：《生物医学工程学杂志》2012年第4期673-676,681,共5页Journal of Biomedical Engineering

摘　　要：本文旨在探讨三维重建CT(3D-CT)在前交叉韧带(ACL)重建术后膝关节的临床价值。本研究所有65例ACL损伤患者均采用单切口股骨和胫骨单骨道方法重建ACL,记录患者术前及术后12个月的Lysholm评分,及膝关节屈膝30°、13.6kg应力条件下KT-1000测量胫骨相对前移距离。全部患侧膝关节在术后1周内和12个月分别进行螺旋CT轴位容积扫描,并行MPR、SSD和MIP三维重建,观察ACL和骨隧道情况。结果发现全部患者手术前及术后12个月Lysholm评分和KT-1000(应力13.6kg)差异显著(P<0.05)。螺旋CT重建图像能够清晰显示ACL重建术膝关节骨隧道的改变及位置、ACL与髁间嵴的关系。术后1周内股骨和胫骨隧道直径分别约为(9.15±0.03)mm和(9.11±0.09)mm,12个月时隧道直径较术后1周分别增加约3%和12%,但其差别均无统计学上差异(P>0.05)。因此,本研究认为多排螺旋CT重建图像能够评价ACL重建术后膝关节,有助于指导术中定位及术后评估。This study evaluated the clinical value of three-dimensional computed tomography（3D-CT）images in the knees following arthroscopic anterior cruciate ligament（ACL）reconstruction. Sixty-five consecutive patients under- went arthroscopic ACL reconstruction with single-incision and single-tunnel techniques. Preoperative and postopera- tive（12 months in between）clinical evaluation were performed using the Lysholm knee score and a KT-1000 arthrom- eter （side to side）. Computed tomography（CT）of the knees was performed in a week after operation in all cases and at mean follow-up of 12 months. All of the clinical evaluation scales performed showed an overall improvement. 3D- CT images can display not only the bone tunnels of the knees including femoral and tibia very distinctly, but also the contour of the reconstructed ACL including adjacent structures. The average femoral tunnel diameter increased sig- nificantly（3%） from （9.15±0.03） mm postoperatively to （9.48±0.5） mm after 12 months; tibia1 tunnel increased significantly（12%）from （9. 11±0.09） mm to （10. 2±0.3） mm. There was no statistical difference between tunnel enlargements. So multi-slices spiral CT can evaluate the contour and changes of contour and changes of the knee after ACL reconstruction, which will be helpful in the intraoperative location and postoperative assessment of the knees.

关 键 词：前交叉韧带 重建 X线摄影术 电子计算机 

分 类 号：R816.8[医药卫生—放射医学]