前交叉韧带重建术后MRI评价和临床评估的相关性分析  

Correlations between MRI evaluation and clinical examination after anterior cruciate ligament reconstruction

作　　者：张君[1] 郭勇[1] 林建宁[2] 

机构地区：[1]海军总医院医学影像科,北京100048 [2]海军总医院骨科,北京100048

出　　处：《局解手术学杂志》2016年第2期98-101,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨膝关节前交叉韧带重建术后磁共振成像的形态及信号强度变化,并与临床术后评估做相关性分析。方法 2013年7月至2015年6月我院34例接受膝关节前交叉韧带重建术的患者于重建术后接受MRI检查,分别从轴位、矢状位及冠状位观察人工交叉韧带的形态、走行及信号强度。采用Rak评估方法对移植物进行评分,临床评估采用物理评估方法,包括前抽屉试验、轴移试验、Lachman试验,采用SPSS 16.0统计软件将二者结果进行相关性分析。结果前交叉韧带重建术后,79%的移植物在整个关节走行均表现为连续低信号(显示良好);15%的移植物表现为信号增高,只有部分为低信号带(中等显示);6%的移植物信号明显增高,走行不连续(显示不佳)。MRI评估结果与临床评估结果差异具有统计学意义(P<0.05),Spearman等级相关系数0.747 2,二者呈明显的正相关。结论磁共振成像作为无创高分辨成像技术,是膝关节前交叉韧带重建术后修复效果评估的有力工具。Objective To evaluate the morphological and signal intensity changes after anterior cruciate ligament reconstruction,and to analyze the correlations between MRI evaluation and clinical examination. Methods Totally 34 patients who underwent anterior cruciate ligament reconstruction in our hospital from July 2013 to June 2015 were given MRI examination. The morphology,orientation and signal intensity of the anterior cruciate ligament grafts were evaluated on axial,sagittal and coronal images. The grafts were assessed with Rak method,and the clinical assessment was adopted with physical assessment method,including drawer test,axial shift test and Lachman test. The correlations between MRI evaluation and clinical examination results were further analyzed by SPSS 16. 0. Results After anterior cruciate ligament reconstruction,79% of the graft were visualized as a smoothly continuous low signal（ well-defined type）,15% of the graft showed increased signal intensity with only a small part of low signal bands（ intermediate type）,and 6% of the grafts showed remarkably increased signal intensity（ indiscernible type）. A statistically significant correlation was identified in MRI evaluation and clinical examination results（ P 〈 0. 05）.Spearman’s correlation coefficient was 0. 747 2 which indicating significantly positive correlation. Conclusion Magnetic resonance imaging is a noninvasive high-resolution imaging technology and it is an effective tool for evaluating anterior cruciate ligament reconstruction.

关 键 词：膝关节 磁共振成像 前交叉韧带重建术 临床诊断 相关性分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]