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目的探讨MRI横断面定量测定指标对髌骨关节不稳的诊断价值。方法回顾性分析髌骨关节不稳患者32例(髌骨关节不稳组)和正常人42例(对照组)的MRI影像学资料。两组均采取仰卧位及双膝完全伸直进行MRI检查,扫描范围均为右侧全膝关节。MRI图像的测量指标包括股骨滑车面对称性、股骨滑车深度、股骨外侧滑车倾斜度、髌骨倾斜角、髌骨外移度、股骨滑车与胫骨结节间的水平距离(TTTG)。结果两组股骨滑车面对称性、股骨滑车深度、股骨外侧滑车倾斜度、髌骨倾斜角、髌骨外移度结果比较,差异有统计学意义(P<0.05),但是两组TTTG结果比较,差异无统计学意义(P>0.05)。股骨滑车面对称性、股骨滑车深度、股骨外侧滑车倾斜度、髌骨倾斜角、髌骨外移度和TTTG的ROC曲线下面积分别为0.954、0.955、0.943、0.922、0.971、0.521;股骨滑车面对称性、股骨滑车深度、股骨外侧滑车倾斜度、髌骨倾斜角、髌骨外移度诊断界值分别为54%、15°、5 mm、16°、3 mm,敏感度为91.3%、85.2%、91.5%、83.1%、79.1%,特异度分别为91.4%、97.5%、88.4%、90.1%、100%。结论在行膝关节伸直位MRI检查时,股骨滑车面对称性、股骨滑车深度、股骨外侧滑车倾斜度、髌骨倾斜角、髌骨外移度对髌骨关节不稳的诊断价值较高。
Objective To investigate the diagnostic value of MRI transverse section quantitative measurement of patellar instability. Methods MRI data of 32 patients with patellar instability (unstable group of the patellar joint) and 42 healthy controls (control group) were retrospectively analyzed. Both groups were taken supine position and knees completely stretched MRI examination, the scope of the scan are the right knee. The measurement of MRI images include the symmetry of the femoral head, the depth of the femoral head, the inclination of the lateral femoral head, the tilt angle of the patella, the lateral shift of the patella, and the horizontal distance between the femoral shaft and the tibial tubercle (TTTG). Results There were significant differences in the results of TTFG between the two groups (P <0.05), the symmetry of the femur, the depth of the femur, the inclination of the lateral femoral trochanter, the tilt angle of the patella and the patellar shift. No statistical significance (P> 0.05). The areas under the ROC curve were 0.954,0.955,0.943,0.922,0.971,0.521 respectively, and the area under the curve of the femur cartilage symmetry, the depth of the femur cartilage, the inclination of the lateral femoral tackle, the tilt angle of the patella, the lateral patella and the TTTG were 0.954, The diagnostic criteria for the accuracy of the femoral trochanter, the depth of the femoral trochanter, the inclination of the lateral femoral trochanter, the tilt angle of the patella and the patellar shift were 54%, 15 °, 5 mm, 16 ° and 3 mm respectively, with the sensitivities of 91.3% and 85.2% 91.5%, 83.1%, 79.1%, and specificity of 91.4%, 97.5%, 88.4%, 90.1%, 100% respectively. Conclusions In the MRI examination of knee extensor position, the diagnosis of patellar joint instability is more valuable in the diagnosis of patellar instability, such as the symmetry of the trochanter surface, the depth of the femoral trochanter, the inclination of the lateral femoral trochanter, the inclination angle of the patella and the patellar shift.