急性髌骨脱位的MR测量与评价

The measureament and evaluation of MR at acute patellar dislocation

目的探讨MRI技术测量、评价急性髌骨脱位(APD)的临床意义。方法回顾性分析48例APD患者并收集性别、年龄相匹配的31例健康志愿者膝关节MRI图像资料,分别测量其髌骨高度(IS指数)、股骨滑车沟角、滑车沟深度、滑车内外侧面比例以及胫骨结节滑车凹槽(TT-TG)距离,并对股骨滑车进行DEJOUR分型。统计学方法采用卡方检验、独立样本T检验。结果 48例APD与31例健康志愿者髌骨高度、股骨滑车沟角、滑车沟深度、滑车内外侧面比例以及TT-TG距离分别为(1.17±0.17)cm,(1.08±0.15)cm、150°±9.7°,140.0°±18.1°、(0.43±0.15)cm,(0.54±0.15)cm、0.50±0.16,0.67±0.10、(16.0±2.30)mm,(14.4±1.32)mm,两组间差异均有统计学意义。APD患者滑车发育不良各分型所占比例明显高于对照组,两者并有显著的统计学差异。结论 MRI技术可准确评价急性髌骨脱位(APD),髌骨高位、股骨滑车发育不良以及TT-TG距离增大是APD发生的高危因素。

Objective To investigate the clinical significance of MRI technique in the measurement and evaluation of acute patellar dislocation（ APD）. Methods It is a retrospective analysis on MRI data consisted of 48 APD patients and 3,gender-and age-matched healthy voluteers between September 2014 and September 2016,which was conducted by two senior radiologists to measure the patellar height（ IS index）,femoral trochlear angle,trochlear groove depth,trochlear internal and external side ratio and TT-TG distance,in addition to evaluating the femoral trochlear DEJOUR type respectively. Chi square test and independent sample T test were used for statistical analysis. Results For 48 cases of APD,the knee joint patellar height,femoral trochlear angle,trochlear groove depth,trochlear internal and external side ratio and TT-TG distance were（ 1. 17 ± 0. 17） cm,150 ° ±9. 7°,（ 0. 43 ± 0. 15） cm,0. 50 ± 0. 16,（ 16. 0 ± 2. 30） mm while,for 31 healthy voluteers,those were（ 1. 08 ± 0. 15） cm,140. 0° ± 18. 1°,（ 0. 54 ± 0. 15） cm,0. 67 ± 0. 10,（ 14. 4 ± 1. 32） mm respectively. All of values between two groups had statistically significant differences; The A,B,C and D type of trochlea DEJOUR type in the APD group compared with the normal control group had a statistically significant difference. Conclusion MRI technique can be used to evaluate acute patellar dislocation（ APD）. The patella alta,femoral trochlear dysplasia and TT-TG distance are the relative high risk factors.