青少年急性髌骨脱位后内侧髌股韧带与骨软骨损伤的MRI分析

MRI Analysis of Injury of Medial Patellofemoral Ligament and Osteochondral Injury in Adolescents after Acute Traumatic Lateral Patella Dislocation

目的分析青少年急性髌骨外侧脱位后,内侧髌股韧带(MPFL)与骨软骨损伤的MRI特点。方法回顾性分析74例经临床证实的急性髌骨外侧脱位青少年患者的MRI资料,所有图像均通过标准位置扫描并由2名放射科医师评估。结果 74例青少年髌骨急性脱位,73例出现MPFL撕裂,其中单纯髌骨侧撕裂32例,单纯股骨侧撕裂18例,体部撕裂2例,多发部位撕裂21例;MPFL撕裂中53例为部分撕裂,20例为完全撕裂。急性脱位后,有53例出现骨软骨损伤,其中单纯髌骨侧31例,股骨侧12例,髌骨-股骨侧10例。结论青少年急性髌骨脱位后,无论MPFL还是骨软骨的损伤均易出现在髌骨侧;部分撕裂较完全撕裂常见,但完全撕裂较部分撕裂更容易出现骨软骨损伤;无论单纯髌骨侧MPFL撕裂或股骨侧MPFL撕裂均容易引起同侧骨软骨损伤。

Objective To analyse the MRI characteristics of the injury patterns of medial patellofemoral ligament（MPFL） and osteochondral injury patterns in adolescents after acute lateral patellar dislocation（LPD）. Methods MR images were obtained in 74 adolescents with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. Results Among 74 adolescents with acute LPD,there were 73 cases with injured MPFL.Fifty-three cases of partial MPFL tear and 20 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion in 32 cases,an isolated femoral attachment in 18 cases,and an isolated mid-substance in 2 cases. More than one site of injury to the MPFL was identified in 21cases. There were 53 cases with osteochondral injury among 74 adolescents with acute LPD,osteochondral injury at patellar attachment in 31cases,at femoral attachment in 12 cases and both at patellar and femoral attachment in 10 cases. Conclusion Injuries most easily occurred at the patellar attachment in adolescents after acute LPD. The partial MPFL tear occurred more commonly than complete MPFL tear,but complete MPFL tear is more commonly concomitant with osteochondral injury than partial MPFL tear. No matter the MPFL tear at patellar attachment or femoral attachment,osteochondral injury occurred easily at the same side.