MRI评估胫股关节形态对前交叉韧带撕裂的影响  

Effect of tibiofemoral joint morphology evaluated by magnetic resonance imaging on the tear of anterior cruciate ligament

作　　者：王静宇 袁亮 林小慧 杨海涛[2] 吕云云 陶奉明 李晓兰 Wang Jingyu;Yuan Liang;Lin Xiaohui;Yang Haitao;LüYunyun;Tao Fengming;Li Xiaolan(Department of Radiology,University-Town Hospital of Chongqing Medical University;Department of Radiology,The First Affiliated Hospital of Chongqing Medical University)

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400042

出　　处：《重庆医科大学学报》2024年第8期1058-1064,共7页Journal of Chongqing Medical University

摘　　要：目的:通过膝关节磁共振成像(magnetic resonance imaging,MRI)探究股骨远端和胫骨近端形态与前交叉韧带(anterior cruciate ligament,ACL)撕裂的相关性。方法:选择2018年1月1日至2023年1月31日于重庆医科大学附属第一医院行膝关节MRI平扫检查的患者,最终选择81例ACL完全撕裂患者(病例组)和82例ACL正常患者(对照组),比较2组患者股骨和胫骨相关解剖学参数,包括髁间窝高度(intercondylar notch height,INH)、髁间窝宽度(intercondylar notch width,INW)、股骨髁宽度(notch width,NW)、髁间窝角(intercondylar notch angle,INA)、股骨内侧髁宽度(medial condyle width,MCW)、股骨内侧髁前后径(medial condyle length,MCL)、股骨外侧髁宽度(lateral condyle width,LCW)、股骨外侧髁前后径(lateral condyle length,LCL)、胫骨内侧平台宽度(medial tibial plateau width,MPW)、胫骨内侧平台前后径(medial tibial plateau length,MPL)、胫骨外侧平台宽度(lateral tibial plateau width,LPW)、胫骨外侧平台前后径(lateral condyle length,LPL)、胫骨髁间嵴角(intercondylar eminence angle,IEA)、内侧胫骨平台角(medial tibial plateau angle,MPA)、外侧胫骨平台角(lateral tibial plateau angle,LPA),计算髁间窝宽度指数(intercondylar notch width index,NWI),采用MCW/LCW、MCL/LCL、MPW/LPW、MPL/LPL描述股骨及胫骨内外侧骨形态学的相对差异,采用MCL/MPL、LCW/LPW、LCW/LPW、LCL/LPL、INA/IEA描述胫股关节之间的一致性;对2组患者进行单因素和多因素logistic分析,对筛选出的独立危险因素进行Logistis联合建模,并行接受者操作特征曲线(receiver operating characteristic curve,ROC)曲线分析。结果:①病例组患者INW、NWI、INA、MCL/MPL小于对照组(P<0.05);病例组患者MCL、MPL、MPW、MCL/LCL、MPL/LPL大于对照组(P<0.05);②多因素分析显示,MCL/MPL、NWI是ACL撕裂的独立危险因素(P<0.05);ROC曲线显示,MCL/MPL、NWI及联合模型对ACL撕裂具有一定的预测价值,曲线下面积(area under Objective:To investigate the correlation between tibiofemoral joint morphology and the tear of anterior cruciate ligament(ACL)based on knee joint magnetic resonance imaging(MRI).Methods:Among the patients who underwent knee joint MRI in The First Affiliated Hospital of Chongqing Medical University from January 1,2018 to January 31,2023,81 patients with complete ACL tear were enrolled as case group,and 82 patients with normal ACL were enrolled as control group.The two groups were compared in terms of the anatomical parameters of the femur and tibia,including intercondylar notch height(INH),intercondylar notch width(INW),notch width(NW),intercondylar notch angle(INA),medial condyle width(MCW),medial condyle length(MCL),lateral condyle width(LCW),lateral condyle length(LCL),medial tibial plateau width(MPW),medial tibial plateau length(MPL),lateral tibial plateau width(LPW),lateral tibial plateau length(LPL),intercondylar eminence angle(IEA),medial tibial plateau angle(MPA),and lateral tibial plateau angle(LPA),and intercondylar notch width index(NWI)was calculated.MCW/LCW,MCL/LCL,MPW/LPW,and MPL/LPL ratios were used to describe the relative differences in bone morphology of the medial and lateral sides of the femur and tibia,and MCL/MPL,LCW/LPW,LCW/LPW,LCL/LPL,and INA/IEA ratios were used to describe the consistency of the tibiofemoral joint.The univariate and multivariate logistic analyses were performed for the two groups,and a logistic joint model was established based on the independent risk factors obtained.A receiver operating characteristic(ROC)curve analysis was also performed.Results:Compared with the control group,the case group had significantly lower INW,NWI,INA,and MCL/MPL ratio(P<0.05)and significantly higher MCL,MPL,MPW,MCL/LCL ratio,and MPL/LPL ratio(P<0.05).The multivariate analysis showed that MCL/MPL ratio and NWI were independent risk factors for ACL tear(P<0.05).The ROC curve analysis showed that MCL/MPL ratio,NWI and joint model had a certain value in predicting ACL tear,with an area under the

关 键 词：前交叉韧带 磁共振成像 膝关节 胫股关节 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.5[医药卫生—诊断学] R322.72[医药卫生—临床医学]