MRI评估股骨内侧髁和胫骨平台匹配性对内侧半月板后根撕裂的影响  

Effect of the match between the medial femoral condyle and tibial plateau on the tear of the posterior root of the medial meniscus evaluated by MRI

作　　者：涂有为 刘云鹏[1,2] 王星亮 彭超 杨家骥 Tu Youwei;Liu Yunpeng;Wang Xingliang;Peng Chao;Yang Jiaji(Wuxi Clinical College of Anhui Medical University,Wuxi 214000,Jiangsu Province,China;The 904 Hospital of the Joint Service Support Force of Chinese PLA,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]安徽医科大学无锡临床学院,江苏省无锡市214000 [2]中国人民解放军联勤保障部队第904医院,江苏省无锡市214000

出　　处：《中国组织工程研究》2022年第12期1872-1876,共5页Chinese Journal of Tissue Engineering Research

基　　金：无锡市科技发展资金项目(CSE31N1618),项目负责人:刘云鹏,项目名称:基于髌股关节三维运动模型的复发性髌骨脱位生物力学研究;无锡市卫生计生委科研项目(Q201772),项目负责人:王星亮,项目名称:内侧髌股韧带重建术对髌股关节解剖形态影响的影像学研究。

摘　　要：背景:股骨髁和胫骨平台的解剖学参数影响膝关节的生物力学,股骨内侧髁和胫骨内侧平台的匹配性可能会影响内侧半月板所受的环状应力大小,从而影响内侧半月板后根撕裂。目的:评估股骨内侧髁和胫骨平台的匹配性对内侧半月板后根撕裂的影响。方法:选择2016年1月至2020年1月因膝关节疼痛于中国人民解放军联勤保障部队第904医院行膝关节MRI检查的患者,最终选择52例确诊为内侧半月板后根撕裂患者(观察组)与40例无骨及软组织解剖结构异常患者(对照组)。在MRI检查图像上测量两组患者的膝关节解剖学参数,股骨内侧髁前后径、胫骨内侧平台前后径、股骨内侧髁横径、胫骨内侧平台横径,计算股骨内侧髁与胫骨内侧平台的横径比、股骨内侧髁与胫骨内侧平台的前后径比。同时进行受试者工作特征(ROC)曲线分析,确定内侧半月板后根撕裂危险因素的临界值。结果与结论:(1)观察组患者的股骨内侧髁横径和股骨内侧髁前后径均大于对照组(P<0.05),股骨内侧髁与胫骨内侧平台的横径比、股骨内侧髁与胫骨内侧平台的前后径比均大于对照组(P<0.05);两组胫骨内侧平台横径、胫骨内侧平台前后径比较差异无显著性意义(P>0.05);(2)ROC曲线分析显示,股骨内侧髁与胫骨内侧平台的横径比最佳截断值为0.85,敏感度57.69%,特异度97.50%,曲线下面积为0.815;股骨内侧髁与胫骨内侧平台的前后径比最佳截断值1.29,敏感度61.54%,特异度95.00%,曲线下面积为0.710;(3)结果表明,股骨内侧髁与胫骨内侧平台的横径比大于0.85与股骨内侧髁与胫骨内侧平台的前后径比大于1.29,可能是内侧半月板后根撕裂发生的重要危险因素,在膝关节MRI冠状位和矢状位测量股骨内侧髁和胫骨内侧平台横径比及前后径比值的方法对诊断内侧半月板后根撕裂具有较高的敏感性和检出率。BACKGROUND:The anatomical parameters of the femoral condyle and tibial plateau affect the biomechanics of the knee joint.The matching of the medial femoral condyle and the medial tibial plateau may affect the magnitude of the annular stress on the medial meniscus,and thus affect the posterior root tear of medial meniscus.OBJECTIVE:To evaluate the effect of the match between the medial femoral condyle and the tibial plateau on the tear of the posterior root of the medial meniscus.METHODS:The data of patients who underwent knee MRI examination at the 904 Hospital of the Joint Service Support Force of Chinese PLA due to knee joint pain from January 2016 to January 2020 were retrospectively analyzed.Finally,52 patients with medial meniscus posterior root tear were selected as observation group;40 patients without abnormal bone and soft tissue anatomy were selected as control group.The anatomical parameters of the knee joint were measured on MRI:medial femoral condyle anteroposterior diameter,medial tibial plateau anteroposterior diameter,medial femoral condyle transverse diameter,and the transverse diameter of the medial tibial plateau.The lateral diameter ratio of the medial femoral condyle to the medial tibial plateau and the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau were calculated.At the same time,receiver operating characteristic curve analysis was performed to determine the critical value of risk factors for posterior root tear of the medial meniscus.RESULTS AND CONCLUSION:(1)The medial femoral condyle transverse diameter and medial femoral condyle anteroposterior diameter were greater in the observation group than those in the control group(P<0.05).The lateral diameter ratio of the medial femoral condyle to the medial tibial plateau and the anteroposterior diameter ratio of the medial femoral condyle to the medial tibial plateau were greater in the observation group than those in the control group(P<0.05).There were no significant differences in the transverse di

关 键 词：膝关节 半月板后根撕裂 匹配性 MRI成像 股骨内侧髁横径 胫骨内侧平台横径 股骨内侧髁前后径 胫骨内侧平台前后径 

分 类 号：R459.9[医药卫生—治疗学] R687.4[医药卫生—临床医学]