急性前交叉韧带损伤中骨挫伤磁共振成像特征及意义  

Magnetic Resonance Image Features of Bone Contusion in Patients with Acute Anterior Cruciate Ligament Injury and Their Significance

作　　者：刘超 尹科[1] 阳志军[1] 刘岸松 戴祝[1] Liu Chao;Yin Ke;Yang Zhijun;Liu Ansong;Dai Zhu(Department of Orthopedics,First Affiliated Hospital of University of South China,Hengyang 421000,China)

机构地区：[1]南华大学附属第一医院骨科中心运动医学专科,衡阳421000

出　　处：《中国运动医学杂志》2023年第7期540-546,共7页Chinese Journal of Sports Medicine

基　　金：湖南省卫健委一般指导项目(202204074533)。

摘　　要：目的:探讨急性前交叉韧带(anterior cruciate ligment,ACL)损伤中骨挫伤的磁共振成像(magnetic resonance image,MRI)影像特征及意义。方法:对2017年1月至2021年12月本院骨科收治的ACL损伤患者的临床资料进行回顾性分析。根据膝关节MRI中ACL损伤部位,分为四组:A组,股骨端断裂,29例;B组,体部断裂,32例;C组,胫骨端断裂,3例;D组,胫骨髁间棘止点撕脱性骨折,20例。分别在MRI矢状面、冠状面T2WI脂肪抑制序列中选取股骨、胫骨骨挫伤面积最大的层面,测量骨挫伤的前后缘距离及中心点距离股骨、胫骨前缘的距离,左右缘距离及其中心点距离股骨、胫骨平台内缘的距离。结果:矢状面,D组较A组及B组胫骨挫伤范围明显增大(P<0.05);D组较A组及B组胫骨挫伤位置明显偏前(P<0.05)。矢状面D组较A组股骨挫伤范围明显增大(P<0.05);D组较A组股骨挫伤位置明显偏后(P<0.05)。冠状位,D组较A组及B组胫骨挫伤范围明显增大(P<0.05);D组较A组胫骨挫伤位置明显偏内(P<0.05)。冠状位上4组患者股骨挫伤范围差异无显著性(P>0.05),挫伤位置差异无显著性(P>0.05)。结论:相比急性ACL实质部断裂,急性ACL胫骨髁间棘止点撕脱骨折挫伤范围更大,胫骨端挫伤位置更偏前、偏内,股骨端挫伤位置更偏后。Objective To explore the magnetic resonance image(MRI)features of bone contusion in patients with acute anterior cruciate ligament(ACL)injury and their significance.Methods Clinical data of patients with ACL injury and admitted to the department of orthopedics of our hospital in the time period from 2017 to 2021 were analyzed retrospectively.According to the location of ACL injury in their knee MRI,all patients were divided into group A of 29 with femoral end fracture,group B of 32 with body fracture,group C of 3 with tibial end fracture and group D of 20 with avulsion fracture of intercondylar spine of tibia.In the MRI sagittal plane and coronal plane T2WI fat suppression se⁃quence,the bone contusion area of femur and tibia with the largest area was selected,and the dis⁃tance between the anterior and posterior edge of bone contusion and the center point to the anterior edge of femur and tibia were measured,together with the distance between the left and right edge of bone contusion and the center point to the inner edge of femur and tibia platform.Results In the sagit⁃tal plane,the range of tibial contusion of group D was significantly larger than group A and B(P<0.05),with the location of the former group significantly more forward than the latter(P<0.05),while the range of femur contusion in group D was significantly larger than that in group A(P<0.05),with significantly lower position in group D than group A(P<0.05).Moreover,in the coronal plane,the con⁃tusion range of tibia in group D was significantly larger than groups A and B(P<0.05),with the contu⁃sion of tibia in group D significantly more inward than group A(P<0.05).However,there was no sig⁃nificant difference in the extent and location of femoral contusion in the coronal plane among the 4 groups(P>0.05;P>0.05).Conclusion Compared with acute ACL parenchymal rupture,acute ACL pa⁃tients with tibial intercondylar avulsion fracture has a larger contusion range,more anterior and inward contusion location of tibial,and more backward contusion l

关 键 词：前交叉韧带损伤 骨挫伤 MRI 影像特征 

分 类 号：R445.2[医药卫生—影像医学与核医学] R683[医药卫生—诊断学]