计算机断层扫描量化伴有J形征的异常髌骨轨迹

发布时间：2018-06-03 23:33

本文选题：复发性髌骨脱位 + 膝关节J形征　；参考：《中国运动医学杂志》2017年09期

【摘要】：目的:利用计算机断层扫描(computed tomography,CT)定量评估伴有J形征的异常髌骨轨迹。方法:本研究为回顾性研究,共纳入53名被诊断为复发性髌骨脱位成年患者,术前嘱患者主动屈伸膝关节,并由两名高年资医师评估髌骨轨迹,根据J形征的有无将患者分为A组(J形征阳性组)和B组(J形征阴性组)。此外,所有患者术前均在伸膝0°位状态下行膝关节CT扫描,并于横断位分别测量髌骨平分指数(bisect offset index,BOI),髌骨外侧位移指数(patellar trochlear-groove distance,PTG)及髌骨外侧倾斜角(patellar lateral tilt,PLT)。最后,比较J形征阳性组与J形征阴性组间的CT测量指数是否存在显著性差异,并利用ROC曲线进一步分析并对比三种参数量化J形征的准确性及稳定性。结果:53例患者中,共有37例(69.8%)呈现J形征阳性,其余16例(30.2%)患者均未见J形征。J形征阳性组患者BOI、PTG及PLT平均值均显著大于J形征阴性组患者。在区分J形征阳性与否的三个指标中,其曲线下面积(AUC)分别为AUC_(BOI)=0.906,AUC_(PTG)=0.883,AUC_(PLT)=0.833,其中BOI的灵敏度为83.3%,特异度为87.5%,cut-off预测值为97.5%。结论:在本研究中53例复发性髌股关节不稳定患者中,近端髌骨轨迹异常(J形征)的发生率为69.8%。可利用CT参数BOI,较好地区分J形征阳性与阴性患者。
[Abstract]:Objective : To evaluate the trajectory of abnormal patella accompanied by J - sign by computed tomography ( CT ) . Methods : Fifty - three adult patients diagnosed as recurrent patellar dislocation were enrolled in this study . The patients were divided into group A ( J - sign positive group ) and group B ( J - shaped sign - negative group ) by two high - year - funded physicians . Results : Of the 53 patients , 37 cases ( 69.8 % ) showed J - sign positive , while the other 16 cases ( 30 . 2 % ) had no J - sign . Among the three indexes , the mean value of BOI , PTG and PLT were 89.3 % , 87.5 % and 97.5 % , respectively .
【作者单位】：北京积水潭医院运动损伤科;
【基金】：北京市医院管理局临床医学发展专项——“扬帆”计划(2013-2017);北京市医院管理局临床技术创新项目(编号:LXMLX201613)
【分类号】：R687.4

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