【摘要】 目的:分析膝關节前交叉韧带(ACL)重建术后进行MRI-3D扫描的可行性。方法:回顾性分析2015年1-12月膝关节ACL损伤患者24例的临床资料,均行ACL重建术。均于术后12个月,进行MRI-2D和MRI-3D检查,比较患者手术前后的Lysholm评分、KT-1000测量的胫骨相对前移距离,比较患者MRI-2D和MRI-3D重建图像上Blumensaat角。结果:术后12个月膝关节Lysholm评分高于术前,且KT-1000测量结果小于术前,比较差异均有统计学意义(P<0.05);MRI-3D和MRI-2D测量的患侧Blumensaat角比较差异有统计学意义(P<0.05),健侧Blumensaat角比较差异无统计学意义(P>0.05),且MRI-3D患侧与健侧Blumensaat角比较差异无统计学意义(P>0.05),而MRI-2D患侧与健侧Blumensaat角比较差异有统计学意义(P<0.05)。结论:MRI-3D较MRI-2D更有利于准确测量Blumensaat角,且ACL重建术后膝关节MRI-3D扫描可常规做术后复查的参考,有助于指导术中定位及术后评估。
【关键词】 前交叉韧带; 磁共振成像; 三维重建
【Abstract】 Objective:To analyze the feasibility of MRI-3D scan after anterior cruciate ligament(ACL)reconstruction of knee joint.Method:The clinical data of 24 patients with ACL injury of knee joint from January to December 2015 were retrospectively analyzed,all patients underwent ACL reconstruction.And all patients underwent MRI-2D and MRI-3D examinations 12 months after operation,the Lysholm score and the relative forward distance of tibia measured by KT-1000 before and after operation were compared,the Blumensaat angles on the reconstructed images of patients between MRI-2D and MRI-3D were compared.Result:The Lysholm score of knee joint after operation 12 months was higher than that of before operation,and the KT-1000 measurement results were lower than that of before operation,the differences were statistically significant(P<0.05).The Blumensaat angles measured by MRI-3D and MRI-2D was compared,the difference was statistically significant(P<0.05),and the Blumensaat angle of the contralateral side was compared,the difference was not statistically significant(P>0.05).The Blumensaat angle between the affected side and the healthy side in MRI-3D was compared,the difference was not statistically significant(P>0.05),the Blumensaat angle between the affected side and the healthy side in MRI-2D was compared,the difference was statistically significant(P<0.05).Conclusion:Compared with MRI-2D,MRI-3D is more advantageous for accurate measurement of Blumensaat angle,and MRI-3D scan of knee joint after ACL reconstruction can be used as a routine reference for post-operative review,which is helpful for guiding intraoperative localization and post-operative evaluation.
【Key words】 Anterior cruciate ligament; Magnetic resonance imaging; Three-dimensional reconstruction
First-author’s address:Guigang People’s Hospital,Guigang 537100,China
doi:10.3969/j.issn.1674-4985.2019.03.003