FasT-Fix和半月板箭修复半月板术后磁共振成像的信号特点  

Comparative Study of Postoperative Magnetic Resonance Imaging of Meniscus Repair with FasT-Fix and Meniscus Arrow

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,北京100191 [2]北京大学第三医院放射科,北京100191

出　　处：《中国微创外科杂志》2013年第11期1021-1025,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金(81041007);北京大学第三医院院内重大课题(BYSY200909);北京市科委"首都市民健康培育项目"(Z111107067311020)

摘　　要：目的 比较FasT-Fix和可吸收半月板箭（Arrow）缝合半月板术后磁共振（MRI）的信号特点和差异.方法 2002年9月～ 2008年12月,112名患者（其中12例内外侧半月板均缝合,共124处半月板缝合）接受关节镜下半月板缝合术,FasT-Fix组73处,Arrow组51处.患者术前及术后接受MRI扫描,比较两种缝合方式的MRI信号特点和差异,并以二次关节镜探查的结果作为金标准计算MRI对两种缝合方式术后愈合情况的诊断价值.结果 二次关节镜探查证实FasT-Fix组和半月板箭组的愈合率分别为74.0％ （54/73）和88.2％ （45/51） （Х^2 =3.794,P=0.051）;MRI综合T2序列对Arrow组愈合情况诊断的准确性（80.4％,41/51）高于FasT-Fix修复组（65.8％,48/73）,但差异无显著性（Х^2=3.176,P=0.075）;在综合T2序列中,FasT-Fix组中未愈合半月板出现3度信号的比例[84.2％ （16/19） vs.50.0％ （3/6）,Х^2=26.142,P=0.000]和累及层面[中位数4（1～6） vs.1（0～3）,Z=3.060,P=0.002]均明显高于Arrow组.结论 MRI综合T2序列对半月板箭修复术后的愈合诊断更准确,FasT-Fix修复术后的半月板更易出现3度信号.Objective To compare the characteristics and the differences of postoperative magnetic resonance imaging （MRI） of meniscus repair with FasT-Fix and meniscus arrow.Metbods The study was performed with 124 menisci of 112 patients,of which 12 knees accepted both medial and lateral meniscus repair.The patients underwent arthroscopic meniscus sutures from September 2002 to December 2008 in our hospital.The repaired menisci were divided into FasT-Fix group with 73 cases and Arrow group with 51 cases.All the patients underwent MRI before and after the operation and the characteristics and differences between the two groups were evaluated and compared.Then the diagnostic value of the MRI for those two techniques was evaluated by using secondlook arthroscopy as the golden standard.Results By second-look arthroscopy,the meniscus healing rate was 74.0% （54/73） and 88.2% （45/51） for the FasT-Fix group and the Arrow group respectively （Х^2 =3.797,P =0.051）.For the integrated T2 sequence of MRI,the diagnostic accuracy of the Arrow group （80.4%,41/51） was higher than that of the FasT-Fix group （65.8%,48/73） with no significant difference （Х^2 =3.176,P =0.075）.For the unhealed meniscus,the incidence [84.2% （16/19） vs.50.0% （3/6）,Х^2 =26.142,P=0.000] and the median number of the involving sequence [4 （1-6） vs.1 （0-3）,Z=3.060,P=0.002] of grade 3 signal of the FasT-Fix group were significantly higher than that of the Arrow group.Conclusions The integrated T2 sequence of MRI was more accurate in diagnosing the healing status of the meniscus arrow than that of the FasT-Fix.The grade 3 signal appears more often in the FasT-Fix sutured meniscus than in the arrow sutured meniscus.

关 键 词：半月板缝合 FAST-FIX 半月板箭 磁共振 二次关节镜 

分 类 号：R687[医药卫生—骨科学]