复发性髌股关节不稳的3.0T MRI评估

3.0T MRI Assessment of Recurrent Patellofemoral Joint Instability

目的:测量复发性髌股关节不稳的解剖指标,为临床诊疗提供依据。方法:对38例复发性髌骨脱位的3.0T MRI资料进行回顾性分析并测量以下参数:描述骨性结构的髌骨Wiberg指数、股骨滑车角、滑车深度、内外侧关节面比例、外侧倾斜角;描述髌骨轨迹的髌骨偏移指数、髌骨倾斜角、髌骨高位指数(Insall-Salvati指数);描述下肢生物力线的胫骨结节-股骨滑车沟(tibia tuberosity-trochlear groove,TT-TG)间距,以及观察髌骨内外侧支持带的情况。结果:两组间髌骨Wiberg指数、股骨滑车角、滑车深度、内外侧关节面比例、外侧倾斜角、Insall-Salvati指数、TT-TG间距的均值有统计学差异(P<0.05);股骨滑车Dejour分型与髌骨Wiberg指数存在显著的负性相关(r=-0.67,P=0.00);髌骨Wiberg指数、股骨外侧倾斜角、TT-TG间距是与髌骨轨迹异常显著相关(r>0.5,P<0.05)。结论:3.0T MRI定量测量可以一定程度上解析复发性髌股关节不稳的解剖因素,为治疗方案的选择提供依据。

Objective:To measure the anatomical parameters of recurrent patellofemoral joint instability and to provide evidence for clinical diagnosis and treatment.Methods:38 patients with recurrent patellofemoral dislocation were retrospectively analyzed by 3.0 T MRI.Measurements included parameters of bony tracking,which were Wiberg Index,sulcus angle(SA),trochlear depth,trochlear facet asymmetry,lateral trochlear inclination(LTI),Insal-l Salvati Ratio(ISR);parameters of patellar tracking,which were characterized by bisect offset index(BSO)and patellar lateral tilt(PTA);biomechanics of lower limbs was characterized by tibial tuberosity-trochlear groove(TT-TG)distance and the patellofemoral ligament was observed.Results:The mean values of Wiberg index,sulcus angle,trochlear depth,trochlear facet asymmetry,lateral trochlear inclination,Insall-Salvati Ratio were statistically significant(P<0.05);There was significant negative correlation between Dejour type and Wiberg index(r=-0.66,P=0.00);The patellofemoral joint malalignment was significantly correlated with lateral trochlear inclination,TT-TG distance and Insall-Salvati ratio(r>0.5,P<0.05).Conclusion:3.0 T MRI quantitative measurement can analyze the anatomical factors of recurrent patellofemoral joint instability,and provide important information for clinical treatment.