半月板缝合术后磁共振成像三度信号特征分析及其临床应用价值  

Characterization of grade 3 MRI signals following meniscal repair

作　　者：江东[1] 敖英芳[1] 苗羽[1] 郑卓肇[2] 余家阔[1] 

机构地区：[1]北京大学第三医院运动医学研究所,100191 [2]北京大学第三医院运动医学研究所放射科,100191

出　　处：《中华创伤骨科杂志》2013年第11期936-941,共6页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金委主任基金（81041007）;首都市民健康培育项目（ZI11107067311020）

摘　　要：目的比较半月板缝合术后愈合和不愈合半月板之间磁共振成像（MRI）3度信号的差别，探讨MRI3度信号对诊断半月板是否愈合的临床价值。方法2007年3月至2008年12月共有39例患者（41个半月板）接受关节镜下半月板缝合术，男29例，女10例；平均年龄为（25．8±6．8）岁。患者于术后平均（17．7±3．3）个月接受MRI检查及二次关节镜探查。根据二次关节镜探查结果，将患者分为愈合组（27例29个半月板）和未愈合组（12例12个半月板），比较愈合组与未愈合组患者半月板MRI3度信号的深度、长度、宽度及强度。结果愈合组中79．3％（23／29）的半月板仍有3度信号。未愈合组患者半月板MRl3度信号深度比值（随访时／术前）明显高于愈合组（PD序列：81．0％4-41．3％m32．3％±33．3％；T2序列：62．8％±42．5％掷．21．3％±33．7％）；随访时MRI3度信号宽度[（2．2±0．8）mmm（1．0±0．6）mm]和强度均明显大于愈合组，以上项目两组间比较差异均有统计学意义（P〈0．05）。愈合组患者随访时半月板MRI3度信号强度较术前明显减弱，差异有统计学意义（P〈0．05）。两组患者术前及随访时半月板MRI3度信号长度比较差异均无统计学意义（P〉0．05）。结论半月板缝合术后MRI3度信号的宽度和强度变化对诊断半月板是否愈合具有较大的临床应用价值。若MRI3度信号深度较浅、宽度较窄、强度较弱，则提示半月板已经愈合。Objective To explore the diagnostic value of grade 3 MRI signals in assessment of meniscal healing by comparing the differences in grade 3 MRI signals between healed and unhealed meniscus. Methods Frum March 2007 to December 2008, 39 patients （41 menisci） received arthroscopic repair of the ruptured meniscus. They were 29 men and 10 women, with a mean age of 25.8 ± 6. 8 years. They underwent MRI examination and second arthroscopy at 17.7 ± 3.3 months postoperation. According to the results of the second arthroscopy, they were divided into a healed group （27 cases and 29 menisci） and an unhealed group （ 12 eases and 12 menisci）. The depth, length, width and intensity of grade 3 MRI signals at the repaired site were compared between the 2 groups. Results The grade 3 signals were still observed in 79.3% （23/29） of the menisci in the healed group. The depth ratio （postoperative/preoperative） in the un- healed group （PD： 8 I. 0% ± 41.3%, 3＂2： 62. 8% ± 42.5% ） was significantly higher than that （PD： 32.3% ± 33.3% ,T2：21.3% ± 33.7% ） in the healed group （ P 〈 0. 05）. The width （2. 2 ± 0. 8 mm versus 1.0 ± 0. 6 mm） and intensity in the unhealed group was significantly higher than in the healed group（ P 〈0.05）. Besides, the signaintensityftheheaedmeniscuswassignificantywerthanthepreperativeeve（P 〈0. 05）. No significant differences were found in terms of the signal length between the 2 groups（ P 〉 0. 05）. Conclusions Changes in the width and intensity of grade 3 M R1 signals following meniscal repair helps a lot the clinical diagnosis of healed and unhealed menisci. The decreased width and intensity of grade 3 MRI signals indicate healing of the meniscus.

关 键 词：半月板 胫骨 磁共振成像 关节镜检查 信号 

分 类 号：R687.4[医药卫生—骨科学]