髌股关节解剖学参数评估髌腱-股外侧髁撞击综合征:基于MRI的对照研究  

Evaluation of anatomical parameters of patello-femoral joint in patellar tendon-lateral femoral condylefriction syndrome:a comparative analysis based on MRI

作　　者：瞿晓春 李勇 姚尧 刘滔 QU Xiao-chun;LI Yong;YAO Yao(Department of Radiology,the Suining Central Hospital,Sichuan 629000,China;不详)

机构地区：[1]遂宁市中心医院放射科,四川遂宁629000 [2]遂宁市第三人民医院放射科

出　　处：《放射学实践》2023年第4期480-484,共5页Radiologic Practice

摘　　要：目的:基于MRI对比分析髌股关节解剖学定量参数(滑车沟角、外侧滑车倾斜度、外侧滑车长度、滑车沟深度、Insall-Salvati指数)在评估髌腱-股骨外侧髁撞击征(PT-LFCFS)中的价值。方法:回顾性将2018年6月-2021年6月在本院经临床诊断为PT-LFCFS的31例患者和髌骨高位但无PT-LFCFS的20例患者及30例健康志愿者(正常对照组)纳入本研究。所有受试者行膝关节MRI扫描(矢状面T1WI及横轴面、冠状面和矢状面脂肪抑制质子加权成像),测量滑车沟角、外侧滑车倾斜度、外侧滑车长度、滑车沟深度和Insall-Salvati指数,采用方差分析比较各定量参数值在3组间的差异,进一步采用最小差异法(LSD)进行组间两两比较。结果:滑车沟角和Insall-Salvati指数在3组间的差异均具有统计学意义(P<0.05),而外侧滑车倾斜度、外侧滑车长度及滑车沟深度在3组间的差异均无统计学意义(P>0.05)。组间两两比较结果显示,Insall-Salvati指数在PT-LFCFS组与髌骨高位组之间的差异无统计学意义(P=0.541),在PT-LFCFS组与对照组、髌骨高位组与对照组之间的差异均有统计学意义(P<0.001);滑车沟角的组间差异均有统计学意义(P<0.001)。在鉴别PT-LFCFS与高位髌骨时,滑车沟角和Insall-Salvati指数的ROC曲线下面积分别为0.877和0.551。结论:MRI能较准确地评估髌股关节解剖变异。滑车沟角可能是髌腱-股骨外侧髁撞击征发生的重要解剖危险因素。Objective:To compare the value of anatomical parameters of sulcus angle,lateral trochlear inclination,lateral trochlear length,trochlear depth and Insall-Salvati index in patellar tendon-lateral femoral condyle friction syndrome(PT-LFCFS).Methods:The dada of 31 cases with PT-LFCFS,20 cases with patella alta(PA group)and 30 cases of healthy control(HC group)were confirmed by clinic were analyzed retrospectively.All subjects underwent knee joint MRI scan(T 1WI sagittal,axial,coronal and sagittal PD fat suppression).The data of anatomical parameters in patello-femoral joint were compared by variance analysis.The least difference method(LSD)was used to compare the anatomical parameters difference between each two groups.Results:The mean sulcus angle and Insall-Salvati index were different among different groups(P<0.001).There was no significant difference between PT-LFCFS and control group in Insall-Salvati index(P=0.541),and was significant difference between the other groups(P<0.001).There were significant difference between diffe-rent groups in Sulcus angle.The areas of sulcus angle and Insall-Salvati index in differential diagnosis of PT-LFCFS and patella alta were 0.877 and 0.551,respectively.Conclusion:MRI can provides accurate assessment of the anatomical variation of the patellofemoral joint.Sulcus angle may be an important anatomic risk factor in patellar tendon-lateral femoral condyle friction syndrome.

关 键 词：髌腱-股骨外侧髁撞击综合征 髌骨高位 解剖学参数 磁共振成像 危险因素 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684.7[医药卫生—诊断学]