磁共振成像对儿童急性创伤性髌骨外侧脱位后膝关节韧带及骨软骨损伤的特点分析  

Analysis on MRI for the characteristics of the injuries of knee joint ligament and cartilage of pediatric patients after acute traumatic lateral patellar dislocation

作　　者：张蕾[1] 刘春生 郭志权 石运力 彭小芳 Zhang Lei;Liu Chunsheng;Guo Zhiquan;Shi Yunli;Peng Xiaofang(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》2025年第1期47-51,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:基于磁共振成像(MRI)分析儿童急性创伤性髌骨外侧脱位后膝关节韧带、骨软骨损伤特点。方法:回顾性分析2020年9月至2023年9月期间唐山市第二医院收治的126例急性创伤性髌骨外侧脱位患儿的临床资料,所有患儿均接受膝关节MRI扫描,按损伤程度分为部分撕裂组(85例)和完全撕裂组(41例)。分析两组患儿内侧髌股韧带(MPFL)损伤、骨软骨损伤的位置和特点。结果:126例患儿均伴有MPFL损伤,其中部分撕裂85例,完全撕裂41例。部分撕裂中单纯髌骨侧34例,单纯股骨侧14例,单纯发中间段9例,多部位损伤28例;完全撕裂组中单纯发生于髌骨侧27例,单纯股骨侧7例,单纯中间段4例,多部位损伤3例。MPFL部分撕裂组与完全撕裂组的单纯髌骨侧和多部位损伤比较,差异有统计学意义(χ^(2)=7.596、10.886,P<0.05)。126例患儿中,91例合并股内斜肌(VMO)损伤,VMO损伤程度与MPFL损伤程度呈正相关(r=0.339,P=0.006)。126例患儿中有119例存在骨软骨损伤,共有损伤部位174个。VMO损伤中,1级损伤的部位以单纯髌骨侧为主,2、3、4级损伤的以多发损伤为主。结论:儿童急性创伤性髌骨外侧脱位多伴有MPFL损伤和骨软骨损伤,且以髌骨侧多发性损伤为主;损伤部位和程度无性别差异;MPFL损伤多合并VMO损伤,且损伤程度与MPFL呈正相关。Objective:To analyze the characteristics of the injury of knee ligament and cartilage in pediatric patients after acute traumatic lateral patellar dislocation based on magnetic resonance imaging(MRI).Methods:Clinical data of 68 pediatric patients with acute traumatic lateral patellar dislocation admitted to The Second Hospital of Tangshan from September,2020 to September,2023 were retrospectively analyzed.All children underwent MRI scan on knee joint.These children were divided into partial tear group(85 cases)and complete tear group(41 cases)according to injury degree.In addition,the location and characteristic of the medial patellofemoral ligament(MPFL)injury and cartilage injury were analyzed.Results:All 126 children had MPFL injury,including 85 cases of partial tear and 41 cases of complete tear.Among the partial tears,34 cases occurred only on the patellar side,14 cases only on the femoral side,9 cases only in the middle segment,and 28 cases had multiple-site injuries.Among the complete tears,27 cases occurred only on the patellar side,7 cases only on the femoral side,4 cases only in the middle segment,and 3 cases had multiple-site injuries.The number of each degree of partial MPFL injury was higher than that of complete injury,and the difference was statistically significant(χ^(2)=7.596,10.886,P<0.05).Among the 126 children,91 cases had VMO injury,and the degree of VMO injury was positively correlated with the degree of MPFL injury(r=0.339,P=0.006).Among the 126 children with acute traumatic lateral patellar dislocation,119 cases had osteochondral injury,with a total of 174 injured sites.The sites of grade 1 injury were mainly on the patellar side,while those of grades 2,3,and 4 injuries were mainly multiple-site injuries.Conclusion:Most of acute traumatic lateral patellar dislocation complicate MPFL injury and cartilage injury in pediatric patients,which mainly focus on patellar side of injury and multiple injury.There are no differences in injury site and degree between different genders.MPFL injury most

关 键 词：急性创伤性髌骨外侧脱位 磁共振成像(MRI) 内侧髌股韧带(MPFL) 软骨损伤 股内斜肌(VMO) 

分 类 号：R445.2[医药卫生—影像医学与核医学]