磁共振成像对儿童及青少年急性外伤性髌骨外侧脱位的系列研究  

Study on MRI for a series of acute traumatic lateral patellar dislocations of children and adolescents

作　　者：彭小芳 张蕾[1] 刘春生 郭志权 石运力 Peng Xiaofang;Zhang Lei;Liu Chunsheng;Guo Zhiquan;Shi Yunli(Department of Radiology,The Second Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]唐山市第二医院放射科,唐山063000

出　　处：《中国医学装备》2024年第6期72-75,86,共5页China Medical Equipment

基　　金：河北省2020年度医学科学研究课题计划(20201447)。

摘　　要：目的:探讨儿童及青少年急性外伤性髌骨外侧脱位的磁共振成像(MRI)表现。方法:回顾性分析2016年7月至2022年4月唐山市第二医院收治的110例急性外伤性髌骨外侧脱位儿童及青少年患儿的患侧与健侧MRI图像。对比分析患儿患侧内侧髌股韧带(MPFL)的撕裂部位与撕裂程度的相关性。按照软骨损伤分级系统(ICRS)将患侧关节软骨损伤分成4级,对比分析关节软骨损伤分级与关节软骨损伤部位的相关性。使用髌骨高度(ISI)、髌滑车指数(PTI)以及Caton-Deschamps指数(CDI)3种髌骨高度测量方法,对比分析患儿患侧膝关节与健侧膝关节髌骨高度的MRI数据差异。结果:110例MPFL损伤患者中部分撕裂73例,完全撕裂37例。MPFL髌骨附着处损伤完全撕裂(22例)与部分撕裂(19例)差异有统计学意义(χ^(2)=11.740,P<0.05),MPFL多发性损伤部分撕裂(40例)与完全撕裂(8例)差异有统计学意义(χ^(2)=10.990,P<0.05);MPFL中间段、股骨起源处损伤部分和完全撕裂比较差异不显著。110例骨软骨损伤中共有病灶162处,按损伤部位分髌骨侧55处,股骨侧33处,多发性损伤74处,骨软骨损伤部位与损伤分级比较差异有统计学意义(χ^(2)=38.153,P<0.05)。儿童及青少年急性外伤性髌骨外侧脱位患儿患侧膝关节ISI、PTI以及CDI均低于健侧(χ^(2)=30.853、12.586、19.656,P<0.05)。结论:儿童及青少年急性外伤性髌骨外侧脱位患儿MPFL的髌骨附着处损伤更容易出现完全撕裂,而多发性损伤更倾向于部分撕裂。患儿关节软骨损伤分级与损伤部位具有相关性。MRI是诊断MPFL损伤的重要方法,为临床治疗提供更多依据。Objective:To explore the manifestations of magnetic resonance imaging(MRI)on acute traumatic lateral patellar dislocation of children and adolescents.Methods:MRI images of the affected side and healthy side of 110 children and adolescents with acute traumatic lateral patellar dislocation who were treated in the Second Hospital of Tangshan from July 2016 to April 2022 were retrospectively analyzed.The correlation of the medial patellofemoral ligament(MPFL)on the affected side between the tear location and tear degree was compared and analyzed.According to the cartilage injury grading system of international cartilage repair society(ICRS),the articular cartilage injury of affected side was divided into 4 grades,and the correlation between the articular cartilage injury grading and the articular cartilage injury location was compared and analyzed.Three methods of measuring patellar height,which included Insall-Salvati index(ISI),patellotrocheal index(PTI)and Caton-Deschamps index(CDI),were used to compare and analyze the differences of MRI data of patellar height between the affected side of knee joint and the healthy knee joint of pediatric children.Results:In 110 patients with MPFL injury,73 cases were partial tears and 37 cases were complete tears.There was significant difference in the injury at MPFL patellar attachment location between complete tears(22 cases)and partial tears(19 cases)(χ^(2)=11.740,P<0.05),and there was significant difference in MPFL multiple injury between partial tear(40 cases)and complete tear(8 cases)(χ^(2)=10.990,P<0.05).There were no significant differences in the injuries of MPFL middle segment and the origin of femur between partial tears and complete tears.There were 162 lesions in 110 cases with osteochondral injury,which included 55 lesions on the patellar side,33 lesions on the femur side and 74 multiple lesions according to the part of injury.There was significant difference between the location of osteochondral injury and injury grading(χ^(2)=38.153,P<0.05).The ISI,PTI and CDI

关 键 词：磁共振成像(MRI) 儿童及青少年 急性外伤性髌骨外侧脱位 

分 类 号：R816.8[医药卫生—放射医学]