外伤性髌骨脱位并内侧髌股韧带损伤3.0T MRI分析及临床意义

Analyses of 3.0 T MRI traits of patellar dislocation with medial patellofemoral ligament damage at the onset of first-time and the clinical significance

目的分析髌骨首次脱位内侧髌股韧带损伤3. 0T MRI表现。方法经临床证实急性首次髌骨脱位且年龄≤25岁的68例患者的3. 0T MRI进行分析,对MPFL损伤程度及部位进行比较。结果急性髌骨外脱位患者中,91. 2%的患者有MPFL损伤,其中32例为韧带I级(无断裂)损伤,12例为韧带II级(部分)损伤,14例为III级(完全)损伤。髌骨段损伤的有40. 3%;股骨段损伤的有29. 0%,其中股骨段浅面完整,深面信号增高疑似损伤的有6. 5%;中间段损伤的有8. 1%;混合部位损伤的有22. 6%。MPFL完全断裂伴有残存MPFL不同程度分层改变的有39例,且大部分发生在混合部位损伤的患者。结论髌骨首次脱位容易伴发MPFL损伤,3. 0T MRI是诊断和分型诊断急性MPFL损伤及术前评估的最好无创检查方法。

Objective To evaluate the 3.0 T magnetic resonance imaging (MRI) manifestations of patients with the firstly patellar dislocation medial patellofemoral ligament injury. Methods We collected the clinical data of 68 patients, who were firstly diagnosed as acute patellar dislocation and were ≤25 years. And then, we used the 3.0 T MRI to compare the degree of MPFL injury and site. Results In these patients, 91.2% of patients had MPFL injury, 32 patients of them were grade Ⅰ ligaments (no fracture) injuries, 12 patients were grade Ⅱ ligaments (part) injuries and 14 patients were grade Ⅲ ligaments (complete) injuries. There were 40.3% of patients with the patella injuries. 29.0% of patients had femoral injuries, and 6.5% of them were suspicion of injury, who were femur superficial integrity but the deep signal increased. The middle position injuries accounted for 8.1% and the mixed position injuries for 22.6%. The 39 patients of MPFL complete rupture had residual MPFL with different degrees change and most of them occurred in mixed position injuries. Conclusion The firstly patellar dislocation is easily occurred MPFL injury. And the 3.0 T MRI was the best noninvasive detection method to diagnosed, types diagnosed the acute MPFL injury and preoperative evaluated.