前交叉韧带重建术后MRI评价与临床评估的对比研究  

Comparative study of MR evaluation and clinical evaluation after anterior cruciate ligament reconstruction

作　　者：张建强 赵卫[1] 何波[1] 张丽芳[1] 张振光[1] 杨磊[1] 郭宏磊[1] ZHANG Jianqiang;ZHAO Wei;HE Bo;ZHANG Lifang;ZHANG Zhenguang;YANG Lei;GUO Honglei(Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032

出　　处：《医学影像学杂志》2021年第10期1764-1768,共5页Journal of Medical Imaging

摘　　要：目的对移植物信号、位置、连续性,骨隧道位置,内固定位置进行评估,对比前交叉韧带重建术后MRI表现与临床检查结果的相关性。方法选取我院运动医学科行前交叉韧带重建手术的患者资料,将140例入组病例分为膝关节稳定组117例,膝关节不稳定组23例,比较两组在骨隧道位置、移植物表现及隧道内固定位置的MRI征象阳性率;Kappa一致性检验比较MRI表现和临床检查结果的一致性。结果膝关节不稳定组在骨隧道位置、移植物情况、内固定装置方面MRI征象阳性率高于稳定组,骨隧道的位置是临床膝关节稳定性判断的重要指标,临床一致性评价Kappa值0.65,移植物的情况与临床一致性评价中等,内固定装置的异常在膝关节不稳定组中特异性最高。结论骨隧道内口位置及扩大、移植物信号与连续性、内固定装置对诊断前交叉韧带重建术后风险期膝关节稳定性有一定价值,MRI可分析导致关节不稳的原因,为临床提供诊断依据。Objective This study evaluates the signal,integrity of the graft,bone tunnel position and internal fixation device,and compares the correlation between the magnetic resonance performance and clinical examination results after anterior cruciate ligament reconstruction.Methods We collected the data of patients undergoing anterior cruciate ligament reconstruction surgery in the Department of Sports Medicine of our hospital from February 2016 to September 2018,divided 140 cases into the group of knee stabilization group(117 cases),knee instability group(23 cases),compared the positive rates of MR signs at the location of the bone tunnel,the appearance of the graft and internal fixation device;the Kappa consistency test was used to compare the consistency of the MR performance and the results of the clinical examination.Results The positive rate of MR signs in the knee instability group was higher than that in the stable group in terms of bone tunnel position,graft condition and internal fixation device.The position of the bone tunnel was an important indicator of clinical knee stability judgment,and the clinical consistency evaluation the Kappa value was 0.65,the condition of the graft was moderate to the clinical consistency evaluation,and the abnormality of the internal fixation device was the most specific in the knee instability group.Conclusion The position and enlargement of the inner opening of the bone tunnel,the signal and integrity of the graft,and the internal fixation device are of certain value for the diagnosis of knee joint stability during the risk period after anterior cruciate ligament reconstruction.Thereby providing clinical evidence for diagnosis.

关 键 词：前交叉韧带重建 磁共振成像 

分 类 号：R686[医药卫生—骨科学] R445.2[医药卫生—外科学]