MRI检测髌骨高度、倾斜角和T_(2)对早期髌骨软化症的诊断价值

Diagnostic values of MRI measurements of patella height,patella tilt angle and T_(2) for early chondromalacia patellae

目的:探究MRI检测髌骨高度(Caton指数)、髌骨倾斜角和T_(2)对早期髌骨软化症的临床诊断价值。方法:前瞻性选取2017年10月至2019年12月某院骨科收治的200例早期髌骨软化症患者作为髌骨软化症组,并选择同期行身体检查的120例健康志愿者作为对照组,比较2组MRI检测的髌骨高度、髌骨倾斜角和T_(2)。采用SPSS 22.0统计学软件分析髌骨高度、髌骨倾斜角和T_(2)与早期髌骨软化的相关性,并通过ROC曲线分析各指标单独及联合诊断早期髌骨软化症的诊断效能。结果:2组的髌骨高度、髌骨倾斜角和T_(2)差异均有统计学意义(P<0.001);髌骨高度和髌骨倾斜角、髌骨高度和T_(2)、髌骨倾斜角和T_(2)间均呈正相关(r=0.227,P<0.001;r=0.285,P<0.001;r=0.368,P<0.001)。分析ROC曲线可得,髌骨高度诊断的敏感度为70.50%、特异度为69.17%、AUC为0.801(95%CI:0.750~0.852),髌骨倾斜角诊断的敏感度为70.00%、特异度为61.67%、AUC为0.760(95%CI:0.707~0.812),T_(2)诊断的敏感度为61.00%、特异度为60.83%、AUC为0.631(95%CI:0.564~0.698),三者联合诊断的敏感度为85.00%、特异度为72.50%、AUC为0.903(95%CI:0.831~0.907)。结论:MRI检测髌骨高度、髌骨倾斜角及T_(2)对髌骨软化症的早期诊断具有重要意义,而三者联合诊断可提高早期髌骨软化症的诊断效能。

Objective To investigate the clinical diagnostic values of MRI measurements of patella height(Caton index),patella tilt angle and T_(2) for early chondromalacia patellae.Methods Two hundred chondromalacia patellae patients admitted to the orthopedic department of some hospital from October 2017 to December 2019 were prospectively selected into a chondromalacia patella group,and 120 healthy volunteers undergoing physical examination during the same period were divided into a control group.MRI measurements of patella height,patella tilt angle and T_(2) were compared in the two groups.SPSS 22.0 statistical software was used to analyze the correlation between MRI measurements of patella height,patella tilt angle,T_(2) and early chondromalacia patellae,and ROC curve was applied to exploring the diagnostic efficacy of each index alone and in combination for the diagnosis of early chondromalacia patellae.Results The differences in MRI measurements of patella height,patella tilt angle and T_(2) between the 2 groups were statistically significant(P<0.001);positive correlations were found between MRI measurements of patella height and patella tilt angle,the ones of patella height and T_(2),and the ones of patella tilt angle and T_(2)(r=0.227,P<0.001;r=0.285,P<0.001;r=0.368,P<0.001).Analysis of the ROC curves showed that MRI measurement of patella height had the diagnosis sensitivity being 70.50%,specificity being 69.17%and AUC being 0.801(95%CI:0.750-0.852),MRI measurement of patella height had the diagnosis sensitivity being 70.00%,specificity being 61.17%and AUC being 0.760(95%CI:0.707-0.812),and MRI measurement of T_(2) had the diagnosis sensitivity being 61.00%,specificity being 60.83%and AUC being 0.631(95%CI:0.564-0.698).The diagnosis by combining MRI measurements of patella height,patella tilt angle and T_(2) had the sensitivity,specificity and AUC being 85.00%,72.50%and 0.903(95%CI:0.831-0.907).Conclusion MRI measurements of patella height,patella tilt angle and T_(2) are of great significance for the early diagnosis of chondromalacia patellae,and the combined diagnosis of the three indexes improves the diagnostic efficacy of early chondromalacia patellae.