基于MRI研究业余马拉松运动员大腿肌肉与膝关节损伤及跑步因素的相关性

The Correlation between Thigh Muscle and Knee Joint Injury and Running Factors in Amateur Marathon Runners

目的基于MRI检查分析业余马拉松运动员大腿前、后群肌肉横截面积(CSA)与身体质量指数(BMI)、跑龄、配速、月跑量和骨髓水肿评分、半月板损伤等级的相关性。方法招募符合标准的马拉松运动员51人。所有受试者均行双侧大腿轴面MRI扫描,在T 1WI上勾画不同肌群CSA。所有受试者另行冠状位、矢状位脂肪抑制质子加权成像(fs-PDWI)序列扫描,根据全关节MRI评分(WORMS)对膝关节骨髓水肿程度进行评分、根据Stoller分级对半月板损伤进行分级。分析大腿前、后肌群CSA与BMI、跑龄、配速、月跑量和骨髓水肿评分、半月板损伤等级的相关性。结果右侧大腿后群肌肉及左侧大腿前群、后群肌肉CSA与BMI呈正相关(r=0.275、0.191、0.231,P<0.05);左侧大腿前群肌肉CSA与左膝外侧半月板后角损伤等级呈负相关(r=-0.286,P<0.05);左侧大腿后群肌肉CSA与配速呈负相关(r=-0.281,P<0.05),与月跑量呈正相关(r=0.229,P<0.05)。结论业余马拉松运动员膝关节外侧半月板损伤与大腿前群肌肉CSA呈明显负相关,对于半月板损伤运动员应加强大腿前群肌肉力量训练。大腿后群肌肉CSA与跑步配速呈明显负相关,为提高跑步成绩应加强大腿后群肌肉力量训练。

Objective To analyze the correlation of cross sectional area(CSA)of anterior and posterior thigh muscles with body mass index(BMI),running age,pace,monthly running volume,bone marrow edema score,and meniscus injury grade in amateur marathon runners based on magnetic resonance imaging.Methods The recruitment process involved the selection of fifty-one marathon runners who met the specified criteria.The bilateral thigh axial plane magnetic resonance scanning was performed on all subjects,and the cross-sectional areas of various muscle groups were delineated on T1WI.All subjects were separately scanned with coronal and sagittal fs-PDWI sequences.The degree of knee bone marrow edema was scored according to the Whole-Organ Magnetic Resonance Imaging Score(WORMS).Meniscus damage was graded according to Stoller scale.The correlation between the cross-sectional area(CSA)of the anterior and posterior thigh muscles and various factors including body mass index(BMI),running experience,pace,monthly running volume,bone marrow edema score,and meniscus injury grade was examined.Results The CSA of the right posterior thigh muscles and the left anterior and posterior thigh muscles were positively correlated with BMI(r=0.275,0.191,0.231,P<0.05).The CSA of the anterior group muscles of the left thigh was negatively correlated with the injury grade of the posterior horn of the left lateral meniscus(r=-0.286,P<0.05).The CSA of left posterior thigh muscles was negatively correlated with pace(r=-0.281,P<0.05)and positively correlated with monthly running volume(r=0.229,P<0.05).Conclusion There is a significant negative correlation between the CSA of the anterior thigh muscles and the lateral meniscus injury in amateur marathon runners.Athletes with meniscus injury should strengthen the strength training of the anterior thigh muscles.The CSA of posterior thigh muscles is significantly negatively correlated with running pace.In order to improve running performance,we should strengthen the strength training of posterior thigh muscles.