前交叉韧带断裂和髌骨脱位急性骨挫伤模式的比较研究

The comparison of the acute bone bruise of femoral condyle between anterior cruciate ligament rupture and patella dislocation

目的比较分析前交叉韧带断裂和髌骨脱位导致急性股骨骨挫伤的位置和范围,为诊断和鉴别诊断提供依据。方法收集27例膝关节急性损伤MRI资料,其中前交叉韧带断裂12例,髌骨脱位15例,分别测量冠状位和矢状位上骨挫伤的位置和范围。结果在矢状位上,髌骨脱位骨挫伤中点位置为(0.36±0.10)cm,较前交叉韧带断裂骨挫伤中点位置的(0.52±0.05)cm明显靠前(P<0.05),骨髓水肿范围明显增大(P<0.05);在冠状位上,髌骨脱位骨挫伤中点位置为(0.16±0.04)cm,较前交叉韧带断裂骨挫伤中点位置的0.32±0.06明显偏外(P<0.05),且骨髓水肿范围明显减小(P<0.05)。结论前交叉韧带断裂和髌骨脱位导致的急性骨挫伤模式显著不同,统计学分析证明这种模式差异可以作为鉴别诊断的依据。

Objective To compare the location and area of acute bone bruise of femoral condyle between ACL （ anterior cruciate ligament） rupture and patella dislocationin order to afford the evidence of differential diagnosis. Methods The data of Magnetic Resonance Imaging（MRI） of twentyseven cases of acute knee injury were collected,which included 12 cases of ACL rupture and 15 cases of patella dislocation. The cases were measured the location and area on both sagittal and coronal images. Results In the sagittal position, the location of patella dislocation （0.36 ±0. 01 ） cm was anterior than the ACL rupture （0.52 ± 0. 05 ） cm significantly （ P 〈 0.05 ）, and the area was larger （ P 〈 0.05 ）. In the coronal position, the location of patella dislocation （0.16 ± 0.04 ） cm was more lateral than the ACL rupture （ 0.32 ±0.06） cm significantly （ P 〈 0. 05 ）, the area of edema was diminished （ P 〈 0.05 ）. Coadusions Significan differences are observed in the location and area of acute bone bruise of femoral condyle between ACL rupture and patella dislocation, which implied that the differences could be important to be used for differential diagnosis.