MRI在解剖型前交叉韧带重建术前后的临床价值研究

Clinical value of MRI before and after anatomic reconstruction of anterior cruciate ligament

目的研究磁共振(magnetic resonance imaging,MRI)在解剖型前交叉韧带重建术中的临床应用价值。方法选取96例接受前交叉韧带重建术的患者(研究组),选取30名无损伤的检查者作为对照组。通过磁共振观察ACL角、PCL指数、PCL夹角、Blumensaat角、胫骨前移情况;通过抽屉实验、Lachman实验、轴移实验,Lysholm的评分标准和膝关节国际评分委员会的膝关节主观评分对研究组患者的膝关节进行评定。术后1年依据Raks法通过磁共振中移植物的完整性和信号进行分级。结果 Rak's法分级结果显示:1级84例患者,3级12例。术后,研究组ACL角、PCL指数、Blumensaat角、胫骨前移均小于术前,差异有统计学意义(P<0.05);且与对照组比较差异均无统计学意义(P>0.05)。对照组的PCL夹角大于研究组术前,术后研究组PCL夹角大于对照组,差异均有统计学意义(P<0.05)。结论 MRI检查能够较好地评价解剖型前交叉韧带手术患者的膝关节恢复情况。

Objective To evaluate the clinical value of MRI before and after anatomic reconstruction of anterior cruciate ligament. Methods Ninety-six patients who underwent anterior cruciate ligament reconstruction were selected as the experimental group. Thirty patients without injuries were chosen as the control group. The ACL angle,PCL index,PCL angle,Blumensaat angle and tibial forward movement were observed by MRI. The knee joint of the experimental group was evaluated by the drawer experiment,the Lachman experiment,the axial shift test,the Lysholm scoring criteria and the knee joint subjective score. After one years,the graft integrity and signal were classified according to the Rak＇s method. Results Results of Rak＇s classification showed that there were 84 cases in Grade 1 and 12 cases Grade 3.After operation,the ACL angle,PCL index,Blumensa angle,and tibial forward movement of the experimental group became smaller than those before operation（ P〈 0. 05）. However,the differences between the two groups in these aspects were not statistically significant（ P〉0.05）. The angle of PCL in the control group was larger than that in the experimental group before operation（ P〈0.05）,and the angle of PCL in the experimental group after operation was larger than that in the control group（ P〈0.05）. Conclusions MRI can serve as a desirable technology for assessing the recovery of knee joint of patients undergoing anatomic reconstruction of anterior cruciate ligament.