前交叉韧带前嵴与前交叉韧带下止点关系的核磁影像学研究

发布时间：2018-07-21 19:02

【摘要】：目的:测量观察研究正常人膝关节核磁(magnetic resonance imaging,MRI)上前交叉韧带(an-terior cruciate ligament,ACL)前嵴与ACL胫骨止点的位置及其相对关系,探讨ACL前嵴对于重建ACL手术下止点定位和术后影像学评估的临床意义。方法:对2015年1月至2016年12月间因膝关节不适就诊于北医三院门诊的年轻患者(18~40岁,平均25.1岁)的膝关节MRI进行回顾性测量观察研究。患者均在同一台核磁共振仪器膝关节完全伸直位时做检查。从Pets终端调出图像,分析未见明显异常的MRI影像共计100例。测量和计算矢状面上胫骨前后径、ACL前嵴距离、ACL前缘距离、ACL后缘距离和ACL中心点距离。结果:矢状面上ACL中心点位于整个胫骨平台的百分比为42.21%±4.3%(28.43%~50.94%),有58例小于43.3%。ACL前嵴距离为13.61±2.17 mm(8.03~18.65 mm),占整个胫骨平台的百分比为26.80%±3.89%(17.74%~33.94%)。ACL前嵴距离与ACL前缘距离高度相关(P0.001,ICC=0.954)。ACL前嵴与ACL前缘的间距为0.56±0.68 mm(-0.28~2.71 mm)。如果以ACL前嵴定位骨道前缘,假设移植物直径8 mm,55度定位,前缘与ACL前嵴间距0.5 mm,则有96例患者重建ACL的移植物中心点在原ACL胫骨止点中心点之前。结论:在MRI矢状面上,ACL前嵴与ACL前缘的位置相距平均0.56 mm,ACL前嵴的位置与ACL胫骨止点前缘具有高度相关性。本研究提示,ACL重建术中,在矢状面上按照ACL前嵴定位的前缘定位法定位胫骨骨道可以比传统的中心点定位法获得更好的靠前定位的结果。
[Abstract]:Objective: to study the position of anterior crest of anterior cruciate ligament (an-terior cruciate ligamentum anterior ligaments) of knee joint and its relative relationship with tibial insertion in normal subjects by nuclear magnetic resonance imaging (magnetic resonance) imaging MRI. To investigate the clinical significance of ACL anterior crest in reconstruction of ACL. Methods: from January 2015 to December 2016, the MRI of knee joint of young patients (1840 years old with an average of 25.1 years) who were hospitalized in the outpatient clinic of the third Hospital of North Medical Hospital from January 2015 to December 2016 were studied retrospectively. All patients were examined with the same MRI instrument when the knee joint was fully stretched. A total of 100 cases of MRI images with no obvious abnormality were analyzed from the pets terminal. The distance between the anterior crest of ACL and the posterior edge of ACL and the distance between the center of ACL and the anterior edge of ACL were measured and calculated on the sagittal plane. Results: the percentage of ACL center on sagittal plane was 42.21% 卤4.3% (28.43c / 50.94%). The distance of anterior crest of ACL was 13.61 卤2.17mm (8.038.65 mm),). The distance of anterior crest of ACL was highly correlated with the distance of anterior edge of ACL (P 0.001 ICC0.954) .ACL anterior cristae were highly correlated with the distance of anterior edge of ACL (P 0.001 ICC0.954). The distance of anterior crest of ACL to the whole tibial plateau was 26.80% 卤3.89% (17.7433.94%). The distance of anterior crest of ACL was highly correlated with the distance of anterior edge of ACL (P 0.001 ICC0.954). The distance between the anterior edge of ACLs is 0.56 卤0.68mm (-0.28m 2.71 mm). If the anterior crest of ACL was used to locate the anterior edge of bone canal, assuming that the diameter of the graft was 8 mm or 55 degrees, and the distance between the anterior edge and the anterior crest of ACL was 0.5 mm, the graft center of the reconstructed ACL in 96 patients was before the central point of the tibial stop of the original ACL. Conclusion: the average distance between the anterior crest of ACL and the anterior edge of ACL on MRI sagittal plane is 0.56 mm and the position of anterior crest of ACL is highly correlated with the anterior edge of tibial stop of ACL. This study suggests that the anterior location of tibial bone canal based on anterior crest location on sagittal plane can obtain better results than that of traditional centroid location in ACL reconstruction.
【作者单位】：北京大学第三医院运动医学研究所北京市运动医学关节伤病重点实验室;
【分类号】：R687.4

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