核磁共振测量下健康股骨髁间窝的形态学指标分析

Morphological index analysis of healthy femoral intercondylar notch under MRI measurement

目的探讨健康髁间窝形态学指标在不同性别、不同髁间窝类型间的差异及与年龄的关系,为髁间窝形态相关疾病发病机制的阐明提供依据。方法对351例(男166例,182膝,女154例,169膝)行膝关节MRI检查未见明显异常(无交叉韧带损伤等疾病)的成年人进行轴位及冠状位测量、计算各形态学指标(冠状位及轴位宽度指数、形态指数、髁间窝容积),依轴位形态对髁间窝分型,并分析各指标与年龄的相关性。数据分析采用SPSS 20.0统计软件进行,两个均值的比较用两独立样本t检验;多个均值的比较用单因素方差分析,率的比较用卡方检验。结果对200例膝进行分型(余151例未找到合适的分型层面),其中A型112例,占56%,U型83例,占41.5%,W型5例,占2.5%,不同性别间各型比例无统计学差异(X^2=2.751,P>0.05);无论轴位还是冠状位髁间窝宽度指数及形态指数在不同性别间无差异,在不同髁间窝形态间差异有统计学意义(F=3.435,P<0.05;F=8.497,P<0.01);髁间窝容积在不同性别(CSA1:t=3.311,P<0.01;CSA2:t=3.267,P<0.01)及不同形态间差异均有统计学意义(F=7.635,P<0.01;F=4.531,P<0.05);髁间窝容积在青年组最大、中年组次之、老年组最小(F=5.346,P<0.05)。结论不同性别间髁间窝宽度指数及形态指数无差异,但髁间窝容积男性显著大于女性;A型髁间窝在3型中最为狭窄;随年龄增长髁间窝有逐渐变小的趋势。

Objective To investigate the difference of morphological indexes of healthy intercondylar notch between different genders and different types of intercondylar notch and their relationship with age,and to provide evidence of the elucidation of the pathogenesis of intercondylar notch related diseases.Methods A total of 351 healthy adult knees(182 knees of 166 males and 169 knees of 154 females)were performed axial and coronal MRI examination and morphological measurements were taken.The indexes were calculated,the types were classified and the relationships between these indexes and age were analyzed.All the data were analyzed using t test,one-way ANOVA and chi-square test by SPSS 20.0.Results Two hundred knees were divided into three types(the other 151 cases could not find the right slice to classify):type A(112 knees,56%),type U(83 knees,41.5%),type W(five knees,2.5%),and there was no significance of the percentages of three types between males and females(2=2.751,P=0.253).The notch width index(NWI)and notch shape index(NSI)of both axial and coronal slices had no significant difference between genders,while there were significant differences among the three intercondylar notch types(F=3.435,P<0.05;F=8.497,P<0.01).The volume of the notch had significant difference both between different genders(CSA1:t=3.311,P<0.01;CSA2:t=3.267,P<0.01)and among different types(F=7.635,P<0.01;F=4.531,P<0.05).The volumes of the young age group was the largest while the elder group were the smallest(F=5.346,P=0.024).Conclusions Among the three types,type A is the narrowest.NWI and NSI show no significant difference between genders,while volume of man is larger than woman.The intercondylar notch tends to be narrower as age increases.