股骨干骨折合并膝关节软骨损伤的磁共振成像与关节镜对比研究

Camparison of MR Imaging and Arthroscopy on Ipsilateral Femoral Shaft Fracture Associated with Articular Cartilage Injury of Knee

目的探讨MR I在股骨干骨折合并膝关节软骨损伤中的应用价值及股骨干骨折合并同侧膝关节软骨损伤的特点。方法对22例股骨干骨折患者行膝关节镜检查的结果和MR I检查的结果进行对比分析。结果 22例患者中MR I发现软骨及骨软骨异常者16例,其中软骨信号改变者3例,软骨形态改变者13例,分为以下4种:(1)软骨缺损2例,(2)软骨局限性变薄2例;(3)软骨表面局部凹凸不平(毛糙)3例;(4)软骨连续性中断呈裂隙状6例。软骨损伤伴发其他关节结构异常改变:膝关节韧带损伤14例,半月板损伤5例。以关节镜检查结果为金标准,MR I对股骨干骨折合并膝关节软骨损伤诊断的灵敏度为83.3%,准确率为81.8%。结论 MR I对股骨干骨折合并同侧膝关节软骨损伤的诊断与关节镜检查结果有良好的一致性,故有重要的应用价值;股骨干骨折合并同侧膝关节软骨损伤的特点:软骨损伤往往作为膝关节损伤的一部分,单独损伤较为少见。

Objective To study the value of MR Imaging in ipsilateral femoral shaft fracture associated with articular cartilage injury of the knee and the characteristics of the femoral shaft fracture associated with articular cartilage injury of the knee.Methods Analyze retrospectively 22 femoral fracture patients,and compare the routine arthroscopic examination with MR Imaging examination of the knee.Results 22 patients examined by MR Imaging were found abnormal cartilage and osteochondral in 16 cases,among which 3 cases changed the cartilage signal and 13 cases changed cartilage shape.Cartilage shape change were divided into the following kinds：（1） cartilage limitation thins in 2 cases;（2）cartilage surface local rough in 3 cases;（3）cartilage continuity broken in 6 cases;（4） cartilage defects in 2 cases.Cartilage injury associated with other joint structures abnormal changes：subchondral bone bruise in 20 cases,knee ligament injury in 14 cases,meniscal tear in 5 cases.Taking arthroscopy as gold standard,MR Imaging had a sensitivity of 83.3% and accuracy of 81.8% in diagnosing femoral shaft fracture associated with articular cartilage injury of knee.Conclusion The results of MR Imaging and arthroscopy correspond with each in diagnosing ipsilateral femoral shaft fracture associated with articular cartilage injury of the knee,for which MR Imaging has great value in application.The characteristics of ipsilateral femoral shaft fracture associated with articular cartilage injury of the knee are that cartilage injury is often a part of knee injuries and is rarely alone.