内侧髌股韧带与股内斜肌在急性髌骨外侧脱位后的MRI表现

MRI findings of medial patellofemoral ligament and vastus medialis obliquus after acute lateral patellar dislocation

目的:分析内侧髌股韧带(MPFL)与股内斜肌(VMO)在急性髌骨外侧脱位后的MRI表现,以及MPFL与VMO损伤的相关性。方法:选择106例急性髌骨外侧脱位患者的MRI资料,分析MPFL、VMO损伤的MRI表现特点,统计损伤程度、部位,并分析相关性。结果:106例中,MPFL损伤发生率为77.4%(82/106),其中部分撕裂、完全撕裂分别占64.6%(53/82)、35.4%(29/82),单纯髌骨侧、股骨侧、多发撕裂发生率分别为22.0%(18/82)、39.0%(32/82)、39.0%(32/82)。VMO损伤发生率为68.9%(73/106),其中1、2级损伤发生率为79.5%(58/73)、20.5%(15/73),单纯髌骨侧、单纯股骨侧、髌骨-股骨侧损伤发生率分别为12.3%(9/73)、54.8%(40/73)、32.9%(24/73)。MPFL与VMO损伤发生率有相关性(χ^(2)=71.744,P<0.001);MPFL损伤程度与VMO损伤程度有相关性(rs=0.428,P<0.001);MPFL单纯髌骨侧、股骨侧撕裂组间伴VMO损伤部位差异有统计学意义(χ^(2)=21.386,P<0.001)。结论:MPFL损伤易合并VMO损伤,以1级损伤为主;MPFL与VMO损伤程度呈正相关,MPFL损伤程度加重,VMO损伤程度随之加重;单纯髌骨侧或单纯股骨侧MPFL损伤均易并发同侧的VMO损伤。

Objective:To analyze the MRI features and correlation of medial patellofemoral ligament(MPFL)and vastus medialis obliquus(VMO)in patients with acute lateral patellar dislocation.Methods:A total of 106 cases of patients with acute patellar dislocation were included.The MRI features of MPFL and VMO injury were retrospectively analyzed,and the correlation analysis on injury degree and location in these two kinds of injury was conducted.Results:The incidence of MPFL injury was 77.4%(82/106),with partial tear and complete tear accounting for 64.6%(53/82)and 35.4%(29/82)and with simple patellar side tear,simple femoral side tear and multiple tears accounting for 22.0%(18/82),39.0%(32/82)and 39.0%(32/82),respectively.The incidence of VMO injury was 68.9%(73/106),with grade 1 and grade 2 injuries accounting for 79.5%(58/73)and 20.5%(15/73),and with simple patellar side,simple femoral side and patella-femoral side injury accounting for 12.3%(9/73),54.8%(40/73)and 32.9%(24/73),respectively.There was a statistical correlation in incidence(χ^(2)=71.744,P<0.001)and injury degree(rs=0.428,P<0.001)between MPFL and VMO injury.There were significant statistical differences in the injury sites of VMO between the simple patellar and simple femoral injury groups(χ^(2)=21.386,P<0.001).Conclusions:MPFL injury is prone to be combined with VMO injury,with grade 1 as the commonest injury.The injury degree of MPFL is positively correlated with that of VMO and with the aggravation of injury degree of MPFL,the injury degree of VMO increases.MPFL injury in patellar side or femoral side is prone to be complicated with ipsilateral VMO injury.