儿童急性髌骨外侧脱位韧带与骨软骨损伤磁共振成像特征及意义  

Characteristics and significance of lateral dislocation of patellar ligament and osteochondral injury of magnetic resonance imaging in children

作　　者：王华 潘宇宁[2] 王福斌 WANG Hua;PAN Yu-ning;WANG Fu-bin(Department of Radiology,Ningbo No.6 Hospital Affliliated to Ningbo University Medical School,Ningbo Zhejiang 315040,China;Department of Medical Imaging,Ningbo First Hospital,Ningbo Zhejiang 315010,China)

机构地区：[1]宁波大学医学院附属宁波市第六医院影像科,浙江宁波315040 [2]宁波市第一医院影像科,浙江宁波315010

出　　处：《中国临床医学影像杂志》2021年第9期652-655,共4页Journal of China Clinic Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2018KY722)。

摘　　要：目的 :研究儿童髌骨外侧脱位韧带与骨软骨损伤磁共振成像(MRI)特征及意义。方法 :选择本院2016年7月—2020年7月73例髌骨外侧脱位患儿作为研究对象,根据MRI征象,分析患儿内侧髌骨韧带(MPFL)损伤部位和程度,骨软骨损伤部位和损伤类型分级。结果:73例患儿髌骨外侧脱位后,均有MPFL损伤;共有5例骨软骨正常,68例骨软骨损伤,伴游离体26块,其中髌骨内侧游离体7块,髁间窝前部游离体3块,髌骨旁骨软骨游离体8块,股骨髁侧后骨性游离体6块,髌骨股骨关节间隙游离体2块。73例MPFL损伤中部分撕裂49例,共67处病灶;完全撕裂24例,共41处病灶。MPFL髌骨附着处部分撕裂损伤比例显著低于完全撕裂,MPFL部分撕裂的多发性损伤比例显著高于MPFL完全撕裂,差异均有统计学意义(P<0.05);MPFL中间段和股骨起源处部分撕裂和MPFL完全撕裂比较,差异均无统计学意义(P>0.05)。68例骨软骨损伤中共有病灶93处,按损伤部位分为髌骨侧32处,股骨侧19处,多发性损伤42处;按损伤形态类型分为Ⅰ级骨软骨损伤20处,Ⅱ级22处,Ⅲ级34处,Ⅳ级17处;不同分级的损伤部位比较,差异有统计学意义(P<0.05)。结论:在MRI征象上,儿童髌骨外侧脱位韧带与骨软骨损伤以髌骨侧、多发性损伤为主,其中又以部分撕裂及Ⅱ、Ⅲ级骨软骨损伤多见,临床可参考进行关节软骨、韧带的修复。Objective: To study the characteristics and significance of lateral dislocation of the patellar ligament and osteochondral injury of magnetic resonance imaging(MRI) in children. Methods: Seventy-three children with lateral dislocation of the patella from July 2018 to March 2020 in our hospital were selected as the study subjects. The location and degree of injury of the medial patellar ligament, the location of osteochondral injury, and the classification of the type of injury were analyzed according to the MR signs. Results: After the lateral dislocation of the patella in 73 children, they all had MPFL injury. There were five cases of normal osteochondral injury, 68 cases of osteochondral injury, with 26 free bodies, including7 free medial patella and 3 free anterior intercondylar fossa, eight pieces of free body adjacent to osteochondral patella, six pieces of free body of bare bone on the posterior side of femur, and two pieces of free body of patella-femoral joint space.Among the 73 cases of MPFL injury, 49 cases were partially lacerated with 67 lesions, and 24 cases were completely lacerated with 41 lesions. The patellar insertion injury of MPFL partial tear was significantly lower than MPFL complete tear,and the multiple injury of MPFL partial tear was significantly higher than MPFL complete tear. The differences were statistically significant(P <0.05). There was no statistically significant difference in the middle segment and femoral origin injuries between MPFL partial tear and MPFL complete tear(P >0.05). There were a total of 93 lesions in 68 cases of osteochondral injury. According to the site of injury, it could be divided into 32 patellar side, 19 femoral side, and 42 on the patella-femoral side. According to the type of injury, there were 20 osteochondral injuries at grade Ⅰ, 22 at grade Ⅱ, 34 at grade Ⅲ, and 17 at grade Ⅳ. Comparisons of injury sites of different grades, the differences were statistically significant(P<0.05). Conclusion: In the MRI signs, the lateral dislocation of the pat

关 键 词：髌骨脱位 髌韧带 骨 软骨 创伤和损伤 磁共振成像 

分 类 号：R684.7[医药卫生—骨科学] R686.5[医药卫生—外科学]