军事训练致膝内侧半月板后角根部撕裂伴移位的影响因素及影像学特点

Influencing factors and imaging characteristics of medial meniscus posterior horn root tear with displacement caused by military training

目的 探讨军事训练致膝内侧半月板后角跟部撕裂伴移位的影响因素及影像学特点。方法 回顾性分析2020年7月至2022年6月102例在武警河北省总队医院经关节镜证实膝内侧半月板后角根部撕裂患者的临床资料及磁共振成像(MRI)特征,其中男84例、女18例,年龄21~45岁[(33.06±5.72)岁]。依据撕裂后是否发生移位将患者分为移位组(35例)和未移位组(67例)。对比移位组和未移位组患者的临床资料及影像学特点。多因素回归分析影响军事训练致膝内侧半月板后角根部撕裂伴移位发生的危险因素。分析MRI对膝内侧半月板后角根部撕裂伴移位发生的诊断效能。结果 移位组半月板绝对脱出量、半月板相对脱出率、内侧胫骨平台软骨退变程度为Ⅲ/Ⅳ度占比高于未移位组(P<0.05)。多因素分析结果显示,半月板绝对脱出量(OR=2.971,95%CI:1.142~8.733)、半月板相对脱出率(OR=3.177,95%CI:1.227~9.261)、内侧胫骨平台软骨退变程度为Ⅲ/Ⅳ度(OR=2.930,95%CI:1.125~7.632)均为影响军事训练致膝内侧半月板后角根部撕裂伴移位发生的影响因素(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,MRI对膝内侧半月板后角根部撕裂伴移位发生诊断的灵敏度、特异度及曲线下面积(AUC)分别为85.71%(95%CI:68.96%~94.62%)、91.04%(95%CI:80.88%~96.31%)、0.884(95%CI:0.805~0.939)。结论 军事训练致膝内侧半月板后角根部撕裂伴移位发生与MRI影像学检查参数半月板绝对脱出量、半月板相对脱出率、内侧胫骨平台软骨退变程度相关,且MRI对膝内侧半月板后角根部撕裂伴移位诊断效能较高。

Objective To investigate the influencing factors and imaging characteristics of medial meniscus posterior horn root tear with displacement caused by military training.Methods The clinical data and magnetic resonance imaging(MRI)characteristics of 102 patients with root tears of the posterior horn of the medial meniscus confirmed by arthroscopy in Hebei Provincial Armed Police Corps Hospital from July 2020 to June 2022 were retrospectively analyzed.There were 84 males and 18 females with a mean age of(33.06±5.72)years(21-45 years).According to the displacement after tear,the patients were divided into displacement group(n=35)and non-displacement group(n=67).The clinical data and imaging characteristics were compared between groups.Multivariate regression analysis was used to analyze the risk factors of medial meniscus posterior horn root tear combined with displacement caused by military training.The diagnostic efficacy of MRI for the root tear of medial meniscus posterior horn with displacement was evaluated.Results The absolute amount of meniscus prolapse,the relative rate of meniscus prolapse and the proportion of patients with gradeⅢ/Ⅳcartilage degeneration of medial tibial plateau in the displacement group were significantly higher than those in the non-displacement group(P<0.05).Multivariate regression analysis showed that the absolute amount of meniscus prolapse(OR=2.971,95%CI:1.142-8.733),the relative rate of meniscus prolapse(OR=3.177,95%CI:1.227-9.261),and gradeⅢ/Ⅳcartilage degeneration of the medial tibial plateau(OR=2.930,95%CI:1.125-7.632)were related to medial meniscus posterior horn root tear with displacement caused by military training(P<0.05).Receiver operating characteristic curve analysis showed that the sensitivity,specificity and area of the curve(AUC)of MRI in the diagnosis of medial meniscus posterior horn root tear with displacement were 85.71%(95%CI:68.96%-94.62%),91.04%(95%CI:80.88%-96.31%)and 0.884(95%CI:0.805-0.939),respectively.Conclusion Medial meniscus posterior horn root tear with displacement caused by military training is related to MRI imaging parameters such as absolute amount of meniscus prolapse,relative of meniscus prolapse rate,and cartilage degeneration of medial tibial plateau.MRI has a high diagnostic efficiency for medial meniscus posterior horn root tear with displacement.