CAJ | 학술논문

目的对比分析青少年与成人急性髌骨外侧脱位后内侧髌股韧带(MPFL)损伤的MRI特点.方法分别对42例青少年和45例成人急性髌骨外侧脱位患者的MRI资料进行回顾性分析,87例患者均行常规MRI矢状面、冠状面和横断面T1 WI、T2WI、脂肪抑制FSE双回波序列扫描,分析MPFL的损伤特点,并应用x2检验比较青少年和成人MPFL各种损伤的发生率.结果急性髌骨外侧脱位后,青少年组MPFL损伤发生率为97.6％ (41/42),其中完全撕裂、部分撕裂发生率分别为57.1％ (24/42)、40.5％(17/42)；成人组对应的MPFL损伤发生率、完全撕裂发生率、部分撕裂发生率分别为100.0％ (45/45)、64.4％(29/45)、35.6％ (16/45)；2组间MPFL损伤的发生率差异均无统计学意义(x2值分别为1.084、0.486、0.223,P值均＞0.05).青少年组MPFL股骨侧、髌骨侧、体部撕裂发生率分别为31.0％(13/42)、78.6％(33/42)和26.2％(11/42),其中多发部位损伤发生率为33.3％ (14/42)；成人组对应的各发生率分别为64.4％(29/45)、40.0％(18/45)、15.6％(7/45)和15.6％ (7/45),2组间比较MPFL股骨侧、髌骨侧撕裂发生率差异有统计学意义(x2值分别为9.759、13.324,P值均＜0.05),体部撕裂发生率差异无统计学意义(x2=1.497,P＞0.05).青少年组较成人组尽管多发部位损伤差异无统计学意义(x2=3.749,P＞0.05),但青少年组更易伴发MPFL多发部位损伤.结论青少年与成人比较,急性髌骨外侧脱位后MPFL损伤程度分布无差异,但在损伤部位分布上,二者具有显著差异,成人组损伤以股骨侧多见,其次为髌骨侧,而青少年组以髌骨侧多见,其次为股骨侧,青少年更易发生MPFL多发部位损伤.
목적 대비분석청소년여성인급성빈골외측탈위후내측빈고인대(MPFL)손상적MRI특점.방법 분별대42례청소년화45례성인급성빈골외측탈위환자적MRI자료진행회고성분석,87례환자균행상규MRI시상면、관상면화횡단면T1 WI、T2WI、지방억제FSE쌍회파서렬소묘,분석MPFL적손상특점,병응용x2검험비교청소년화성인MPFL각충손상적발생솔.결과 급성빈골외측탈위후,청소년조MPFL손상발생솔위97.6％ (41/42),기중완전시렬、부분시렬발생솔분별위57.1％ (24/42)、40.5％(17/42)；성인조대응적MPFL손상발생솔、완전시렬발생솔、부분시렬발생솔분별위100.0％ (45/45)、64.4％(29/45)、35.6％ (16/45)；2조간MPFL손상적발생솔차이균무통계학의의(x2치분별위1.084、0.486、0.223,P치균＞0.05).청소년조MPFL고골측、빈골측、체부시렬발생솔분별위31.0％(13/42)、78.6％(33/42)화26.2％(11/42),기중다발부위손상발생솔위33.3％ (14/42)；성인조대응적각발생솔분별위64.4％(29/45)、40.0％(18/45)、15.6％(7/45)화15.6％ (7/45),2조간비교MPFL고골측、빈골측시렬발생솔차이유통계학의의(x2치분별위9.759、13.324,P치균＜0.05),체부시렬발생솔차이무통계학의의(x2=1.497,P＞0.05).청소년조교성인조진관다발부위손상차이무통계학의의(x2=3.749,P＞0.05),단청소년조경역반발MPFL다발부위손상.결론 청소년여성인비교,급성빈골외측탈위후MPFL손상정도분포무차이,단재손상부위분포상,이자구유현저차이,성인조손상이고골측다견,기차위빈골측,이청소년조이빈골측다견,기차위고골측,청소년경역발생MPFL다발부위손상.
Objective To compare and analyze MRI characteristics of medical patellofemoral ligament(MPFL) injury patterns in adolescents and adults after acute lateral patellar dislocation.Methods MR images of 42 adolescents and 45 adults after acute lateral patellar dislocation were retrospectively reviewed.Routine MR scanning was performed in axial,sagittal and coronal planes,including T1 WI,T2 WI and fat saturation sequence.The x2-tests were performed to analyze the MPFL injury patterns between adolescent group and adult group.Results The prevalence rate of MPFL injury was 97.6％ (41/42) in adolescent group after acute lateral patellar dislocation,including 57.1％ (24/42) of complete tear and 40.5％ (17/42) of partial tear.The prevalence rate of MPFL injury was 100.0％ (45/45) in adult group,including 64.4％ (29/45) of complete tear and 35.6％ (16/45) of partial tear.There were no statistical difference between adolescents and adults in prevalence rate of MPFL injury,complete MPFL tear,partial MPFL tear (x2 =1.084,0.486,0.223 ; P ＞ 0.05).The prevalence rate of MPFL injury at femoral attachment,patellar attachment and midsubstance were 31.0％ (13/42),78.6％ (33/42) and 26.2％ (11/42) respectively in adolescent group,whereas they were 64.4％ (29/45),40.0％ (18/45) and 15.6％ (7/45) respectively in adult group.It occurred at multiple sites in 33.3％ (14/42) of adolescents,and in 15.6％ (7/45) of adults.There were significant differences between adolescents and adults in the prevalence rate of MPFL tear at femoral attachments and patellar attachments (x2 =9.759,13.324 ; P ＜ 0.05),but there was no statistical difference at its midsubstance (x2 =1.497,P ＞ 0.05).Although not statistically significant (x2 =3.749,P ＞ 0.05),MPFL tear at multiple locations were seen more in adolescents than in adults (33.3％ vs.15.6％).Conclusion The injury degree and distribution of MPFL are similar in adolescents and adults after acute lateral patellar dislocation,but there is significant difference in the site of MPFL injury distribution between adolescents and adults.MPFL is most easily injured at femoral attachment,secondly at patellar attachment in adults,while MPFL is most easily injured at patellar attachment,secondly at femoral attachment in adolescents.Adolescents are more likely to have multiple-site MPFL injury than adults.