胫骨平台内侧髁亮角征的MRI表现及临床意义

The shiny-corner sign of the tibial plateau medial condyle: MRI appearances and clinical significance

目的:描述胫骨平台内侧髁亮角征的MRI表现并分析其与内侧半月板-骨软骨复合体(MOCU)之间的关系。方法:对2014年1—5月已行MRI平扫的227例膝关节共209例患者的临床及影像学资料进行回顾性分析。结果:70例膝关节显示亮角征,其中51例位于胫骨平台内侧髁的内侧缘,12例位于后缘,7例位于前缘。具有亮角征的患者的年龄((59.75±13.52)岁)大于无亮角征的患者((47.86±15.02)岁)。亮角征对内侧半月板撕裂检出的敏感性、特异性、阳性预测值和阴性预测值分别为61%、91%、83%和76%。亮角征与内侧半月板撕裂及周缘性移位具有相关性(P<0.001)。结论 :膝关节胫骨平台内侧髁亮角征与内侧半月板撕裂相关,并认为半月板具有保护其覆盖的胫骨平台功能。

Objective： To describe the MRI findings of the shiny-corner sign of the tibial plateau medial condyle and to analysis its association with the medial meniscal-osteochondral unit. Methods： Clinical data and MRI findings of 209 patients with 227 knees MRI exams were performed, from January to May 2014, were analyzed retrospectively. Results： Seventy knees demonstrated a shiny-corner sign and 51 cases involved the medial rim of the medial tibial plateau, 12 cases involved the posterior rim in and the anterior rim in 7 cases. Patients with shiny-corner sign were older than patients without shiny-corner sign（mean age（59.75±13.52） years vs（47.86±15.02） years）. The presence of a shiny-corner sign could detect a tear of the medial meniscus with a sensitivity, specificity, positive predictive value, and negative predictive value of 61%, 91%, 83%, and76%, respectively. The shiny-corner sign was associated with tears of the medial meniscus and radial displacement of the meniscus in the knee（P0.001）. Conclusion： Shiny-corner sign of the knee is associated with tears of the menisci and according to this we believe the concept that the menisci had the function to protect the underlying covered portions of the tibial plateau.