少年膝关节Ⅴ型骨挫伤的影像学诊断

Imaging diagnosis of type Ⅴ bone contusion of knee joint in juvenile

目的探讨少年膝关节Ⅴ型骨挫伤的影像学表现特点及影像学成像手段的选择。方法回顾性分析本院2017-2019年32例少年膝关节Ⅴ型骨挫伤的资料。所有患者均有患膝X线及磁共振成像(MRI)检查资料,7例同时行CT检查。结果 MRI与X线在髌骨形态分类、髌骨脱位或半脱位、高位髌骨的诊断上,差异无统计学意义(P>0.05);MRI可明确显示本病特征性的髌骨内下缘及股骨外髁前外缘的骨髓水肿及伴发的髌股内侧支持带损伤,而X线均无法明确显示,差异具有统计学意义(P<0.001);在明确诊断伴发的骨软骨剥脱性损伤方面,MRI(24例)明显优于X线(2例),差异具有统计学意义(P<0.001)。结论 MRI可显示少年膝关节Ⅴ型骨挫伤的病变特征,宜作为该病首选的影像学检查手段。

Objective To explore the imaging features of type Ⅴ bone contusion of knee joint in juvenile and the application options of imaging technology. Methods The data of 32 cases with knee joint type Ⅴ bone contusion in juvenile from 2017 to 2019 in our hospital were retrospectively analyzed. All patients had X-ray and MRI examination data of the affected knee, 7 patients underwent CT examination simultaneously. Results There was no statistical difference between MRI and X-ray in the diagnosis and classification of patella morphology, diagnosis of patellar dislocation or subluxation, and high patella(P>0.05). MRI clearly showed the characteristic contusion edema of the inferomedial patella and the lateral femoral condyle as well as rupture of the medial patellofemoral ligament, but these features could not be observed on X-rays, which had statistically significant differences(P<0.001).MRI(n=24)was better than X-ray(n=2) for the diagnosis of osteochondral exfoliative injury,which had statistical difference(P<0.001). Conclusion MRI can show the pathological characteristics of Ⅴ-type bone contusion of knee joint in juvenile, and it should be the preferred imaging method for this disease.