低场MRI在髌股外侧高压综合征诊断中的应用评价

Evaluation of Low-i eld MR in the Diagnosis of Excessive Lateral Pressure Syndrome for Patellofemoral Joint

目的探讨低场MRI在髌股外侧高压综合征(ELPS)中的应用价值及可行性。方法搜集2010年3月-2013年3月经手术或临床确诊为ELPS患者37例,使用德国西门子公司0.35 T永磁型开放式MRI扫描仪,采用自旋回波序列T2WI、抑脂像短时间仅转恢复(STIR)等序列对经手术或临床确诊为ELPS患者的患膝行横断面及矢状面扫描。评估髌骨骨性结构、髌下脂肪垫、髌内外侧支持带,并测量髌骨倾斜角值。结果 37例ELPS患者中,WibergⅡ、Ⅲ、Ⅳ型髌骨分别为15、21、1例,髌骨倾斜角逐渐增大,以Ⅳ型为甚。二分髌骨3例,髌下脂肪垫水肿37例,髌外侧支持带短缩增厚25例,髌股外侧软骨面不同程度的软化29例。结论低场MRI能提供ELPS较直观的影像诊断依据,具有较高的价值及临床意义,其中STIR序列是诊断ELPS的最佳序列。

Objective To investigate the value and feasibility of low-field MR in the diagnosis of excessive lateral pressure syndrome （ELPS） of the patellofemoral joint. Methods Thirty-seven patients confirmed to have ELPS by surgery or clinical examination between March 2010 and March 2013 were involved in this retrospective study. The injured knees of all patients were examined by SE sequence and Fat sequence, using Siemens 0.35 T MR scanner. The patella was assessed. Infrapatellar fat pad, patella tilt angle and patellofemoral joint space were measured. Results There were 15 cases of type Ⅱ , 21 of type Ⅲ, and 1 of type Ⅳ knees. Three cases of bipartite were detected. Patella tilt angle： type Ⅳ〉 type Ⅲ 〉 type Ⅱ . Infrapatellar fat pad had edema in 37 cases. And there were 29 cases of varying degrees of lateral patellar cartilage softening. Conclusions Low-field MRI is an effective diagnostic method of excessive lateral pressure syndrome for patellofemoral joint. STIR sequence is the best sequence for diagnosing patellofemoral excessive lateral pressure syndrome.