膝关节MRI错位征在预测髌骨脱位患者股骨前倾角中的临床应用

Clinical application of dislocation sign on knee magnetic resonance imaging：a new predictor of excessive femoral anteversion in patients with patellar dislocation

摘要:

目的：建立一个新的影像学标志以预测髌骨脱位患者是否合并过大的股骨前倾角。方法：回顾性分析2016年1月至2018年7月于我院就诊的35例髌骨脱位患者的临床资料。男4例，女31例。平均年龄21.3岁。纳入患者的股骨前倾角为28.3°±8.3°，胫骨扭转角为29.0°±8.9°，股胫参数-1.3±11.1。将膝关节MRI的错位征定义为股骨髁间窝外侧壁与胫骨平台外侧髁间嵴的错位。膝关节MRI错位征阳性层面数为1.49±1.25。结果：纳入的35名患者中有25人出现错位征。错位征阳性与阴性的组别中股骨前倾角存在显著性差异（P<0.05）。股骨前倾角的数值则与错位征在膝关节MRI出现的层面数量呈显著相关（P<0.05）。结论：错位征可见于髌骨脱位患者膝关节MRI中，并且可作为预测患者是否合并股骨前倾角过大的影像学指标之一。其股骨前倾角的数值可通过膝关节MRI中错位征出现的层面数加以预测。

Abstract:

Objective：To investigate whether the dislocation sign on knee magnetic resonance imaging（MRI） can be used to predict excessive femoral anteversion in patients with patellar dislocation. Methods：A retrospective analysis was performed on the clinical data of 35 patients（4 males and 31 females） with patellar dislocation who attended our hospital from January 2016 to July 2018. The mean age was 21.3 years. The femoral anteversion angle was 28.3°±8.3°. The tibial torsion angle was 29°±8.9°. The femorotibial index was -1.3±11.1. The dislocation sign on knee MRI was defined as malalignment between the lateral wall of intercondylar fossa of the femur and the lateral intercondylar eminence of the tibial plateau. The number of frames with dislocation sign was 1.49±1.25. Results：Dislocation sign was observed in 25 of the 35 patients. There was a significant difference in femoral anteversion angle between the patients with dislocation sign and those without dislocation sign（P<0.05）. The femoral anteversion angle was significantly correlated with the number of frames with dislocation sign on knee MRI（P<0.05）. Conclusion：Dislocation sign can be identified on knee MRI and can be a predictor of excessive femoral anteversion in patients with patellar dislocation. The femoral anteversion angle can be es－timated by the number of frames with dislocation sign.