MR定量测量指标在青少年髌骨不稳中的诊断应用价值

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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.

Key words： Magnetic resonance imaging Patellofemoral joint index Quantitative measurement Adolescent Patellar instability Diagnosis

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	YAN Bin1 Aikepaer·Wubuli2 GUI He1

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YAN Bin1 Aikepaer·Wubuli2 GUI He1. Diagnostic value of MR quantitative measurement indexes in patellar instability in adolescents[J]. 中国医药导报, 2018, 15(34): 144-148.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I34/144

[1] 李宁，张志强.复发性髌骨脱位诊治及治疗选择[J].中华临床医师杂志：电子版，2017，11（6）：142-145.
[2] 高玉龙，陈丽，乔建民，等.屈膝30°体位CT扫描对青少年习惯性髌骨脱位的诊断价值[J].中国骨与关节损伤杂志，2017，32（3）：327-328.
[3] Tigchelaar S，van Essen P，Bénard M，et al. A self-centring osteotomy of the tibial tubercle for patellar maltracking or instability：Results with ten-years' follow-up [J]. Bone Joint J，2015，97-B（3）：329-336.
[4] Chhabra A，Subhawong TK，Carrino JA. A systematised MRI approach to evaluating the patellofemoral joint [J]. Skeletal Radiol，2011，40（4）：375-387.
[5] 阮文辉，李宏波，谢鹏，等.成人复发性髌骨脱位的术前影像学评估与联合手术[J].中华骨与关节外科杂志，2016， 9（1）：57-61.
[6] Charles MD，Haloman S，Chen L，et al. Magnetic resonance imaging-based topographical differences between control and recurrent patellofemoral instability patients [J]. Am J Sports Med，2013，41（2）：374-384.
[7] Meyers AB，Laor T，Sharafinski M，et al. Imaging assessment of patellar instability and its treatment in children and adolescents [J]. Pediatric Radiol，2016，46（5）：618-636.
[8] Carrillon Y，Abidi H，Dejour D，et al. Patellar instability：assessment on MR images by measuring the lateral trochlear inclination-initial experience [J]. Radiology，2000，216（2）：582-585.
[9] 贾梦岩，史占军，肖军，等.髌股关节形态学与髌骨软化症之间相关性研究[J].中国临床解剖学杂志，2016，34（3）：343-347，351.
[10] 闫斌，侯彦杰，徐超.骨骺未闭青少年TT-TG距离参考值的建立及其与髌骨不稳的相关性研究[J].实用骨科杂志，2017，23（3）：231-234.
[11] 路坦，刘晓潭，柴明祥，等.青少年髌骨骨软骨骨折16例的临床分析[J].中国医药导报，2016，13（6）：87-90.
[12] 叶琴，龚向阳.重视髌骨不稳的影像学诊断[J].现代实用医学，2018，30（1）：2-4.
[13] 何友武，许超，范秋平，等.髌股关节病的研究进展[J].中国现代医生，2017，55（23）：160-164.
[14] 吴志钢，张雁伟，李静，等.MRI横断面定量测定指标对髌骨关节不稳的诊断价值[J].广西医学，2016，38（1）：78-81.
[15] 刘纯.MRI在股骨滑车发育不良诊断的临床应用价值[J].中国CT和MRI杂志，2016，14（11）：129-131.
[16] Niimoto T，Deie M，Adachi N，et al. Quantitative stress radiography of the patella and evaluation of patellar laxity before and after lateral release for recurrent dislocation patella [J]. Knee Surgery Sports Traumatol Arthrosc，2014，22（10）：2408-2413.
[17] 黄晋，谢兴文.髌骨不稳人群与正常人群髌骨运动轨迹的对比研究[J].中国中医骨伤科杂志，2018，26（2）：72-75.
[18] 吴俊峰，刘丽思，郑卓肇，等.MR横断面定量测量指标对髌股关节不稳患者的诊断价值[J].中华放射学杂志，2014，48（8）：659-663.
[19] Salzmann GM，Weber TS，Spang JT，et al. Comparison of native axial radiographs with axial MR imaging for determination of the trochlear morphology in patients with trochlear dysplasia [J]. Arch Orthop Trauma Surg，2010， 130（3）：335-340.
[20] 高畅，王文涛，徐磊，等.MR定量测量指标对复发性髌骨不稳的诊断价值[J].放射学实践，2017，32（10）：1051-1056.
[21] Petri M，Ettinger M，Stuebig T，et al. Current Concepts for Patellar Dislocation [J]. Arch Trauma Res，2015，4（3）：e29301.
[22] Pal S，Besier TF，Beaupre GS，et al. Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta：an upright，weightbearing MRI study [J]. J Orthop Res，2013，31（3）：448-457.