Diagnostic value of MR quantitative measurement indexes in patellar instability in adolescents
YAN Bin1 Aikepaer·Wubuli2 GUI He1
1.Department of Orthopedics, the Second Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830002, China;
2.the First Department of Orthopedics, North Hospital of People′s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, Urumqi 830002, China
Abstract：Objective To analyze the diagnostic value of magnetic resonance (MR) quantitative measurement indexes in patellar instability in adolescents. Methods Forty-eight cases (48 knees) of adolescent patients with patellar instability (case group) treated in Department of Orthopedics of the Second Affiliated Hospital of Xinjiang Medical University and 30 cases of healthy young volunteers for health check-ups and recruitment (control group) from June 2016 to May 2018 were selected as research objects. They were given MR plain scan for knee joint. Related quantitative indexes were measured on cross-sectional fat-reducing FSE PDWI, including patellar deviation index, patellar tilt angle, patellar external displacement, trochlear groove angle, lateral femoral trochlear tilt angle, and tibial tuberosity-trochlear groove distance (TT-TG). And the receiver operating curve (ROC) was used to analyze the diagnostic efficacy of indexes for patellofemoral joint instability. Results Compared with control group, the patellar deviation index, patellar tilt angle, patellar external displacement, trochlear groove angle and TT-TG in case group were significantly larger, and the lateral femoral trochlear tilt angle was significantly smaller, the differences were statistically significant (P ＜ 0.05). The patellar deviation index, patellar tilt angle, patellar external displacement and trochlear groove angle of female adolescent patients with patellar instability were lager than those of male adolescent patients with patellar instability, the differences were statistically significant (P ＜ 0.05). And there was no significant difference between male and female adolescents with patellar instability in lateral femoral trochlear tilt angle and TT-TG (P < 0.05). Among MR quantitative measurement indexes, the areas under the ROC curve of patellar deviation index, patellar tilt angle, patellar external displacement, trochlear groove angle, lateral femoral trochlear tilt angle and TT-TG were all＞0.9, and the sensitivity and specificity of diagnosing patellar instability in adolescents were all＞85%. Conclusion In the state of knee extension, MR quantitative measurement of patellofemoral joint indexes have a high diagnostic efficiency for patellar instability in adolescents. There are gender differences in the patellar deviation index, patellar tilt angle, patellar external displacement and trochlear groove angle, which has a certain guiding role in the assessment of patellar instability in adolescents with different gender.
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2018, Vol. 15 
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