基于MRI的非接触性前交叉韧带撕裂与膝关节解剖学危险因素的相关性研究  

Researsch of correlation between non-contact anterior cruciate ligament tear and anatomical risk factors of knee joint based on MRI

作　　者：高慧晶 许尚文 林姗 王荣靖 GAO Hui-jing;XU Shang-wen;LIN Shan;WANG Rong-jing(Department of Medical Imaging,Fuzhou Second General Hospital,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院影像科,福建福州350007 [2]联勤保障部队第九〇〇医院放射诊断科,福建福州350028

出　　处：《创伤与急危重病医学》2025年第1期59-64,共6页Trauma and Critical Care Medicine

摘　　要：目的探讨非接触性前交叉韧带(ACL)撕裂与髌骨位置、股骨滑车发育不良、α角之间的相关性。方法选取2019年4月至2022年7月在福州市第二总医院行常规膝关节MRI检查且经关节镜证实ACL撕裂的135例患者作为ACL撕裂组,男性99例,女性36例,年龄(25.9±7.9)岁,年龄范围为15~46岁。随机选取同期100例ACL正常、仅膝关节腔少量积液的纳入者作为正常组。比较ACL撕裂组与正常组的髌骨位置、股骨滑车形态学指标和α角之间的差异。采用二元logistic回归分析评估性别、髌骨位置、股骨滑车形态和α角对研究对象发生ACL撕裂的影响。结果男性ACL撕裂发生率高于女性,差异有统计学意义(P<0.05)。ACL撕裂组胫骨结节上缘到髌软骨下极距离、改良的IS(MIS)指数、股骨滑车沟深度、滑车沟角及a角增大与正常组比较,差异均有统计学意义(P<0.05)。二元Logistic回归分析显示,髌骨高位(OR=2.86,P<0.05)、滑车沟角(OR=10.18,P<0.05)、α角(OR=1.18,P<0.05)分别是ACL撕裂的独立预测因子。受试者操作特征曲线分析结果显示,增大的MIS指数、增大的滑车沟角和较大的α角与ACL撕裂的风险增加相关。结论ACL撕裂患者的胫骨结节上缘到髌软骨下极距离、MIS指数、股骨滑车发育不良发生率和α角均高于ACL正常的膝关节人群。Objective To investigate the correlation between non-contact anterior cruciate ligament(ACL)tears and patellar position,femoral trochlear dysplasia,and theαangle.Methods 135 patients who underwent arthroscopically confirmed ACL tears and had routine preoperative MRI examinations at our hospital between April 2019 and July 2022,serving as the ACL tears group.Meanwhile,100 cases of knee MRI without ACL tears from the same period were randomly selected as the control group.The differences in patellar position,femoral trochlear morphology,andαangle between the ACL tear group and the normal group were compared.Binary logistic regression was used to assess the effects of gender,patellar position,femoral trochlear morphology,andαangle on the occurrence of ACL tears in the study population.Results The incidence of ACL tears was higher in males than in females,with statistically significant differences between groups(P<0.05).Compared to the control group,the ACL tear group showed statistically significant differences in the distance from the upper edge of the tibial tubercle to the inferior patellar cartilage,the MIS index,femoral trochlear groove depth,trochlear groove angle,andαangle(P<0.05).Binary logistic regression analysis showed that patella alta(OR=2.86,P<0.05),trochlear groove angle(OR=10.18,P<0.05),and theαangle(OR=1.18,P<0.05)were independent predictors of ACL tears.Receiver operator characteristic curve analysis indicated that an increased MIS index,enlarged trochlear groove angle,and greaterαangle were associated with an increased risk of ACL tears.Conclusion Patients with ACL tears had a higher distance from the upper edge of the tibial tubercle to the inferior patellar cartilage,higher MIS index,higher incidence of femoral trochlear dysplasia,and greaterαangle compared to individuals with normal ACLs.

关 键 词：膝关节 前交叉韧带 滑车发育不良 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]