CT与MRI在青少年急性髌骨脱位影像评估中的效果比较  

Comparison of CT and MRI in the imaging evaluation of acute patellar dislocation in adolescents

作　　者：武一恒 赵洪波[1] 周宏艳[1] 李骏然 王泊凯 张金龙 Wu Yiheng;Zhao Hongbo;Zhou Hongyan;Li Junran;Wang Bokai;Zhang Jinlong(Department of Orthopedics,The Second Hospital of Tangshan,Tangshan 063000,China;Graduate School,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]唐山市第二医院骨科,唐山063000 [2]华北理工大学研究生院,唐山063000

出　　处：《中华创伤骨科杂志》2025年第2期156-162,共7页Chinese Journal of Orthopaedic Trauma

摘　　要：目的通过比较CT与MRI影像学评估胫骨结节外偏及滑车发育不良指标的差异,探讨各指标的最佳影像学评估模式。方法回顾性分析了2014年1月至2024年9月间唐山市第二医院骨科收治的73例急性髌骨脱位患者的CT和MRI影像学资料。男37例(左膝21例,右膝16例),女36例(左膝19例,右膝17例);年龄为15(13,16)岁。在MRI影像上测量的髌腱-滑车沟(PT-TG)距离与CT影像上测量的胫骨结节-滑车沟(TT-TG)距离进行比较。同时分别在MRI和CT影像上测量胫骨结节-罗马拱(TT-RA)距离、滑车沟角(SA)、滑车深度(TD)、外侧滑车倾斜(LTI)和滑车面不对称性(TFA)并进行比较。结果CT测量的TT-TG距离[(20.47±4.42)mm]大于MRI测量的PT-TG距离[(17.89±4.23)mm],差异有统计学意义(t=-4.047,P<0.001)。CT测量的TT-RA距离[(24.28±4.27)mm]、TD[2.95(2.36,4.08)mm]、LTI(15.4°±3.85°)、TFA[0.42(0.38,0.49)]均大于MRI测量的结果[(21.34±3.99)mm、2.52(1.64,2.98)mm、14.11°±3.58°、0.38(0.34,0.44)],差异均有统计学意义(P<0.001)。CT测量的SA(151.30°±6.74°)小于MRI测量的结果(159.06°±5.40°),差异有统计学意义(P<0.001)。各指标的观察者内一致性ICC值均大于0.9,观察者间一致性ICC值均大于0.85。结论CT与MRI评估的各指标存在差异性。在评估胫骨结节外偏时,MRI测量的PT-TG距离和CT测量的TT-RA距离更为准确;MRI测量的滑车发育不良指标能更准确地反映其严重程度。ObjectiveTo explore advantages of CT and MRI imaging in clinical assessment of specific indicators(trochlear dysplasia and tibial tubercle lateralization)of acute patellar dislocation in adolescents by comparing CT versus MRI imaging.MethodsA retrospective study was conducted to analyze the CT and MRI imaging data of 73 patients with acute patellar dislocation who had been admitted to Department of Orthopedics,The Second Hospital of Tangshan from January 2014 to September 2024.There were 37 males(21 left knees and 16 right knees)and 36 females(19 left knees and 17 right knees),with a mean age of 15(13,16)years.On MRI images,the distance between the patellar tendon-trochlear groove(PT-TG)was measured.On CT images,the distance between the tibial tuberosity-trochlear groove(TT-TG)was measured.Additionally,the distance from the tibial tubercle-Roman arch(TT-RA),the sulcus angle(SA),the trochlear depth(TD),the lateral trochlear inclination(LTI),and the trochlear facet asymmetry(TFA)were measured on both MRI and CT images.ResultsThe TT-TG measured on CT[(20.47±4.42)mm]was significantly greater than that on MRI[(17.89±4.23)mm](t=-4.047,P<0.001).The TT-RA[(24.28±4.27)mm],TD[2.95(2.36,4.08)mm],LTI(15.4°±3.85°),and TFA[0.42(0.38,0.49)]measured on CT were all significantly greater than those on MRI[(21.34±3.99)mm,2.52(1.64,2.98)mm,14.11°±3.58°,0.38(0.34,0.44)](P<0.001).The SA measured on CT(151.30°±6.74°)was significantly less than that measured on MRI(159.06°±5.40°)(P<0.001).The intra-observer ICC values for all indicators were greater than 0.9,and the inter-observer ICC values greater than 0.85.ConclusionsThere are differences between CT and MRI in each indicator in evaluation of acute patellar dislocation in adolescents.The PT-TG measured on MRI and the TT-RA measured on CT can better evaluate the tibial tubercle lateralization;the indicators for trochlear dysplasia measured on MRI respond better to the severity of trochlea dysplasia than those on CT.

关 键 词：青少年 髌骨脱位 对比研究 CT MRI 

分 类 号：R68[医药卫生—骨科学]