内翻型膝关节骨性关节炎骨性结构影像学特征之间内在联系  

The intrinsic relationship between imaging features of the bony structure in varus-type knee osteoarthritis

作　　者：方长海 樊慧慧 魏海民 汪源 FANG Changhai;FAN Huihui;WEI Haimin;WANG Yuan(Department of Radiology,Wuhu Hospitalof Traditional Chinese Medicine,Wuhu,Anhui Province 241000,China)

机构地区：[1]芜湖市中医医院影像科,安徽芜湖241000

出　　处：《实用放射学杂志》2025年第2期271-275,共5页Journal of Practical Radiology

摘　　要：目的探讨内翻型膝关节骨性关节炎(KOA)骨性结构影像学特征之间内在联系。方法回顾性选取99例确诊为内翻型KOA患者,所有患者均进行标准负重位双下肢全长X线摄影术及膝关节三维CT检查。在图片存储与传输系统(PACS)工作站观察分析图像,测量髋-膝-踝(HKA)角、胫骨内侧平台沉降值,测量骨赘大小并进行分级,统计软骨下假囊肿的分布。对上述影像指标进行相关性分析,线性相关则绘制散点图。结果HKA角与胫骨内侧平台沉降值之间存在相关性,相关系数(r)为-0.548;各亚分区的骨赘分级与HKA角均存在相关性,r分别为-0.324、-0.307、-0.534、-0.581、-0.468、-0.245、-0.265、-0.244、-0.706、-0.741、-0.726、-0.326、-0.712、-0.218;髌骨内侧、股骨内侧亚分区、胫骨内侧亚分区骨赘分级与胫骨内侧沉降值之间存在相关性,r分别为0.227、0.263、0.295、0.242、0.297、0.361、0.407,其余亚分区骨赘分级与胫骨内侧沉降值之间无相关性;骨赘分级与软骨下假囊肿之间总体存在相关性,r为0.245,但有亚区域性差别。股骨内侧骨赘分级与软骨下假囊肿之间无相关性,其余各分区均存在相关性,r分别为0.213、0.230、0.200、0.147。结论KOA是整个全膝关节疾病,其HKA角、胫骨内侧平台沉降值、骨赘分级、软骨下假囊肿骨性结构影像学特征之间既有内在联系,又存在亚区域性差别,且受解剖结构的影响。Objective To explore the intrinsic relationship between imaging features of the bony structure in varus-type knee osteoarthritis(KOA).Methods A total of 99 patients diagnosed with varus-type KOA were retrospectively selected.All patients underwent standard weight-bearing full-length X-ray radiographs of both lower extremities and 3D CT scans of the knee joints.The images were observed and analyzed at the picture archiving and communication system(PACS)workstation.The hip-knee-ankle(HKA)angle and tibial medial plateau settlement value were measured,the size of osteophyte was measured and graded,and the distribution of subchondral pseudocysts was counted.Correlation analysis was performed on the above imaging indicators,and scatter plots were drawn for linear correlations.Results There was a correlation between the HKA angle and the tibial medial plateau settlement value,with a correlation coefficient(r)of-0.548.The osteophyte grades in each subregion were correlated with the HKA angle,with r of-0.324,-0.307,-0.534,-0.581,-0.468,0.245,-0.265,-0.244,-0.706,-0.741,-0.726,-0.326,-0.712,-0.218,respectively.There was correlation between the osteophyte grades in the medial patella,medial femoral subregion,and medial tibial subregion and the tibial medial settlement value,with r of 0.227,0.263,0.295,0.242,0.297,0.361,and 0.407,respectively.No correlation was found between the osteophyte grades in other subregions and the tibial medial settlement value.There was an overall correlation between osteophyte grades and subchondral pseudocysts,with a r of 0.245,but with regional differences.No correlation was found between the medial femoral osteophyte grades and subchondral pseudocysts,while correlations were observed in other zones,with r of 0.213,0.230,0.200,and O.147,respectively.Conclusion KOA is a disease of the entire knee joint.The imaging features of its bony structure,including the HKA angle,tibial medial plateau settlement value,osteophyte grades,and subchondral pseudocysts,have both intrinsic relationship and regiona

关 键 词：骨性关节炎 计算机体层成像 骨赘 髋-膝-踝角 

分 类 号：R684.3[医药卫生—骨科学] R814.42[医药卫生—外科学]