MRI定量分析髌股关节形态与髌骨软化症之间相关性研究

MRI quantitative analysis of the correlation between patellofemoral morphology and chondromalacia patellae

目的运用MRI测量并分析髌股关节形态参数,探讨其与髌骨软化症(CP)之间相关性。方法回顾性分析经临床及MRI诊断为CP者64例(CP组),测量其髌股关节形态参数,并收集70例无CP者为对照组,比较两组髌股关节形态参数是否存在差异。结果CP发生于髌骨外侧关节面42例;CP组髌Wiberg指数显著小于对照组(P=0.000),髌骨倾斜角、髌骨I-S指数显著大于对照组(P=0.002、0.044);CP组滑车内外侧关节面比值、外侧滑车倾斜角、滑车深度均显著小于对照组(P=0.012、P=0.008、P=0.000),滑车沟角显著大于对照组(P=0.000)。结论CP好发于髌骨外侧关节面;髌骨Wiberg指数、滑车内外侧关节面比值、外侧滑车倾斜角、滑车深度对诊断CP有一定的诊断效能;提示髌骨不稳和滑车发育不良可能是导致CP的病因之一。

Objective To measure and analyse the morphological parameters of patellofemoral joint on MRI,so as to explore its correlation with chondromalacia patellae.Methods Retrospective analysis was conducted on 64 patients with CP diagnosed by Clinical and MRI(CP group),the morphological parameters of patellofemoral joint was measured,and 70 patients without CP were collected as the control group,the differences of the morphological parameters of patellofemoral joint were compared between two groups.Results CP occurred in lateral facet(42 cases).The patellae wiberg index of the CP group was significantly smaller than that of the control group(P=0.000).The patellar tilt angle and patellar I-S index of the CP group were significantly greater than that of the control group(P=0.002,0.044).The trochlear facet ratio,lateral trochlear inclination angle and trochlear depth were significantly smaller than that of the control group(P=0.012,P=0.008,P=0.000).The sulcus angle was significantly greater than that of the control group(P=0.000).Conclusion CP often occurs in the lateral facet;The patellae Wiberg index,trochlear facet ratio,lateral trochlear inclination angle and trochlear depth have a certain diagnostic efficiency to diagnose CP;This suggests that patellar instability and trochlear dysplasia may be one of the causes of CP.