复发性髌骨脱位术后膝关节MRI表现与临床功能的相关性分析  

MRI Findings and Clinical Function After Combined Surgery for RecurrentPatella Dislocation:A Comparative and Correlational Study

作　　者：邓云杨 徐海芸 颜方方 陈梦宇 李梅[1] DENG Yunyang;XU Haiyun;YAN Fangfang;CHEN Mengyu;LI Mei(Department of Radiology,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University School of Medicine;Department of Radiology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine;Department of Radiology,TEDA International Cardiovascular Hospital)

机构地区：[1]上海交通大学医学院附属第六人民医院放射科,上海200233 [2]上海中医药大学附属上海市中医医院放射科 [3]泰达国际心血管病医院放射科

出　　处：《中国医学计算机成像杂志》2024年第4期490-495,共6页Chinese Computed Medical Imaging

基　　金：上海市临床重点专科(shslczdzk03203)。

摘　　要：目的:观察复发性髌骨脱位患者术前与术后膝关节MRI表现,评估术后膝关节MRI表现与临床功能评分的相关性。方法:根据手术方式将研究对象分为二联术与三联术组。2组患者均于术前及术后6个月以上行MRI扫描,并进行Kujala及Lysholm评分。分别在MRI图像上测量髌骨倾斜角、外侧髌股角、股骨滑车适合角、髌骨外侧移位值、股骨外侧滑车倾斜度、Wiberg指数和Caton-Deschamps指数,评估股骨滑车发育不良等级及术后髌骨外侧关节软骨损伤等级。比较2组患者术前与术后各MRI参数的变化及术后组间临床功能评分差异,并将术后MRI参数值与临床功能评分作相关性分析。结果:二联术组与三联术组术后髌骨倾斜角、髌骨外侧移位值、股骨滑车适合角及Caton-Deschamps指数均较术前减小,外侧髌股角较术前增大(P<0.05);三联术组术后髌骨倾斜角小于二联术组(P<0.05)。二联术组术后Kujala评分及Lysholm评分均较三联术组高,其中Lysholm评分差异具有统计学意义(P<0.05)。二联术组术后Caton-Deschamps指数和髌骨外侧面软骨损伤分级均与Kujala评分具有相关性,分别呈低度负相关(r=-0.398,P=0.044)和中度负相关(r=-0.457,P=0.019)。结论:复发性髌骨脱位术后MRI检查可观察髌股关节对位及软骨损伤情况,并反映膝关节临床功能变化。Purpose:To evaluate pre-operative and postoperative knee MRI findings in patients with recurrent patellar dislocation(RPD),and to evaluate the correlation between knee MRI findings and clinical function scores.Methods:Based on the surgical procedures,the subjects were divided into two groups,the double-surgery group and the triple-surgery group.Both groups of patients underwent MRI scans of the knee preoperatively and at least 6 months postoperatively.Kujala and Lysholm scores were also obtained for all patients.Patellar tilt angle(PTA),lateral patellofemoral angle(LPA),congruence angle(CA),lateral patellar displacement(LPD),lateral femoral trochlear inclination(LTI),Wiberg index and Caton-Deschamps index(CDI)were measured on MRI images,and the grade of femoral trochlear dysplasia and lateral articular cartilage injury of patella were evaluated.The preoperative and postoperative MRI manifestations were observed in both groups of patients.The postoperative MRI manifestations were compared between the two groups and a correlation analysis was conducted to assess the relationship between postoperative MRI manifestations and clinical functional scores.Results:In both groups,postoperative PTA,LPD,CA,and CDI were significantly reduced when compared to preoperative levels,while LPA was significantly increased(P<0.05).The postoperative PTA in the triple-surgery group was smaller than that in the double-surgery group(P<0.05).The double-surgery group was with higher postoperative Kujala and Lysholm scores when compared to the triple-surgery group,and the difference of Lysholm scores was with statistical significance(P<0.05).In the double-surgery group,postoperative CDI and the grading of lateral patellar articular cartilage injury showed correlation with Kujala scores,and presented as a weak negative correlation(r=-0.398,P=0.044)and a moderate negative correlation(r=-0.457,P=0.019),respectively.Conclusion:MRI can observe the patellofemoral joint alignment and cartilage injury after surgery for recurrent patellar dislocatio

关 键 词：复发性髌骨脱位 磁共振成像 膝关节功能评分 

分 类 号：R445.2[医药卫生—影像医学与核医学]