髂胫束摩擦综合征MRI特征及发病机制相关研究

MRI features and related study on pathogenesis of iliotibial band friction syndrome

目的:分析髂胫束摩擦综合征(ITBFS)的MRI影像学特征与其可能发病机制的相关性,进一步加深对该病的认识。方法:搜集40例临床诊断为ITBFS患者的MRI图像,并与对照组(膝关节MRI未见明显异常)进行比较,分析ITBFS的MRI影像学特征,探讨ITBFS MRI征象与可能发病机制的关系。结果:髂胫束摩擦综合征MRI影像学主要表现为髂胫束增厚及髂胫束内侧积液。病例组与对照组ITBT、ITBSCA及LFCHI差异具有统计学意义(Z=-6.97,P<0.001;Z=-6.26,P<0.001;Z=-2.83,P=0.005)。身高与ITBCSA及LFCHI呈中度正相关(r=0.67,P<0.001;r=0.65,P<0.001);病程与ITBT、ITBSCA呈轻度正相关(r=0.48,P=0.002;r=0.45,P=0.004);LFCHI与ITBCSA呈轻度正相关(r=0.47,P=0.002)。结论:ITBFS在MRI上具有一定特征性,主要表现为ITB增厚和髂胫束内侧积液。髂胫束增厚多出现在病程较长的患者,并且外侧股骨髁突出易发生ITBFS,证明股骨外上髁反复运动、摩擦及ITB内侧结构压迫导致的慢性炎症反应是主要的发病因素。

Objective:To analyze the correlation between MRI features of iliotibial band friction syndrome(ITBFS) and its possible pathogenesis.Methods:MRI images of 40 patients with ITBFS were collected and compared with control group(MRI of knee joints showed no obvious abnormality).The MRI features of ITBFS were analyzed, and the relationship between MRI signs and possible pathogenesis of ITBFS was discussed.Results:The main MRI manifestations of ITBFS were thickening of iliotibial tract and effusion in the medial iliotibial tract.The differences of ITBT, ITBSCA and LFCHI between the case group and the control group were statistically significant(Z=-6. 97,P<0.001;Z=-6.26,P<0.001;Z=-2.83,P=0.005).Patient’s height was positively correlated with ITBSCA and LFCHI(r=0.67,P<0.001;r=0.65,P<0.001).The course of disease was slightly positively correlated with ITBT and ITBSCA(r=0.48,P=0.002);r=0.45,P=0.004);LFCHI was slightly positively correlated with ITBSCA(r=0.47,P=0.002).Conclusion:ITBFS has some characteristics on MRI.The main manifestations are thickening of ITB and effusion in the medial iliotibial tract.The thickening of iliotibial tract often occurs in patients with long course of disease, and the lateral femoral condyle is prone to ITBFS,which proves that the chronic inflammatory reaction caused by repeated movement, friction of the lateral femoral epicondyle and compression of the internal structure of the ITB is the main pathogenic factor.