股骨滑车发育不良患者髌骨形态的MRI测量研究  

MRI measurement of patellar morphology in patients with femoral trochlear dysplasia

作　　者：林小慧 杨雨蒙 唐锐 聂蕾 李晓兰 张瑞珂 LIN Xiaohui;YANG Yumeng;TANG Rui;NIE Lei;LI Xiaolan;ZHANG Ruike(Department of Radiology,University-Town Hospital of Chongqing Medical University,Chongqing 401331,China;Department of Radiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属大学城医院放射科,重庆401331 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《现代医药卫生》2023年第16期2761-2767,共7页Journal of Modern Medicine & Health

摘　　要：目的通过膝关节磁共振成像(MRI)平扫分析股骨滑车发育不良(FTD)患者的髌骨形态学。方法选择2015年1月1日至2022年3月10日在重庆医科大学附属第一医院行膝关节MRI平扫的133例FTD患者作为病例组,并选择同期67例滑车正常的患者作为对照组。根据性别及FTD的严重程度,将病例组分为男性低级别FTD组(ML组)、男性高级别FTD组(MH组)、女性低级别FTD组(FL组)、女性高级别FTD组(FH组),将对照组分为男性对照组(MC组)、女性对照组(FC组)。所有检查均使用相同的MRI扫描仪进行。在MRI轴位及矢状位上分别测量各组患者髌骨的宽度、厚度、Wiberg软骨角、Wiberg软骨下角、Wiberg指数、Wiberg分型和前后径、长轴长度,以及对髌后软骨的厚度及损伤情况进行评估。结果FTD患者的髌骨更窄、更薄、更短,整体形态更短小,髌骨外侧关节面占比更高,髌骨关节面的软骨角比骨性角度更大,髌后软骨更厚(P<0.05);随FTD程度的加重,髌骨的外侧关节面越宽,内侧关节面发育短窄,形态不稳定者占比更高(P<0.05);髌软骨损伤的概率与FTD的严重程度、性别之间无明显相关性(P>0.05);男性较女性的髌骨整体上更宽、更厚、更长,髌骨软骨面更平坦,矢状位上的髌后软骨更厚,差异均有统计学意义(P<0.05),而女性髌骨的形态随FTD严重程度的增加更偏小。结论FTD患者会并发髌骨发育不良,且髌骨的骨性形态与软骨形态不具有一致性;FTD所导致的髌股关节应力改变应是髌骨形态异常的重要致病因素;髌软骨损伤的概率与FTD的严重程度、性别之间无相关性;髌骨的形态具有性别差异,且女性髌骨形态更易受到FTD严重程度的影响。Objective To evaluate the morphology of patella in patients with femoral trochlear dysplasia(FTD)on magnetic resonance imaging(MRI)plain scan of knee joint.Methods A total of 133 patients diagnosed with FTD by knee joint MRI plain scan in the First Affiliated Hospital of Chongqing Medical University from January 1,2015 to March 10,2022 were collected as the study group,and 67 patients with normal trochlear at the same time were selected as the control group.According to gender and the severity of FTD,the study group was divided into the male low-level FTD group(Group ML),the male high-level FTD group(Group MH),the female low-level FTD group(Group FL),and the female high-level FTD group(Group FH).The control group was divided into the male control group(Group MC)and the female control group(Group FC).All examinations were performed with the same MRI scanner.The width,thickness,Wiberg cartilage angle,Wiberg subchondral angle,Wiberg index,Wiberg classification,anteroposterior diameter and long axis length were measured in transverse and sagittal MRI of the knee joint,respectively,and the thickness and damage of retropatellar cartilage were evaluated similarly.Results In FTD patients,the patella was narrower,thinner and shorter,the overall shape was shorter,the proportion of the lateral articular surface of the patella was higher,the cartilage angle of the articular surface of the patella was larger than the bone angle,and the retropatellar cartilage was thicker(P<0.05).With the severity of FTD,the lateral articular surface of the patella was wider,the medial articular surface was short and narrow,and the proportion of protrusion was higher(P<0.05).There was no significant correlation among the probability of retropatellar cartilage injury,the severity of FTD,gender(P>0.05).The patella of male was wider,thicker,and longer than that of female,with a flatter patellar cartilage surface and thicker retropatellar cartilage in the sagittal view,and the differences were statistically significant(P<0.05).With the increase of

关 键 词：股骨滑车发育不良 髌骨 髌软骨 形态学 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]