目的 根据青少年的膝关节MRI图像测量髌骨不稳相关参数，对比髌骨不稳患者与髌股关节关系正常者髌周脂肪垫MRI形态、信号改变，探究髌周脂肪垫MRI异常征象对于青少年髌骨不稳症的早期诊断意义。 方法 从2020年10月至2023年10月于宁波市第二医院接受膝关节MRI检查的10~17岁青少年人群中筛选研究对象，经纳排后测量髌骨不稳相关影像学参数，将其分为病例组与对照组，将两组的髌周脂肪垫水肿数量进行统计，采用统计学软件SPSS20（IBM Corp）及R4.1.2进行数据分析。 结果 在340例膝关节MRI受试者中，分别有162例、204例及106例出现髌下脂肪垫、髌上脂肪垫及股前脂肪垫水肿；病例组（160例）与对照组（180例）在年龄、性别、侧别及主诉方面无显著差异（P>0.05）；病例组各髌周脂肪垫水肿发生率高于对照组（P<0.05）；病例组多灶性水肿比例显著高于对照组（35.00% vs 11.11%，P<0.001）；病例组中髌骨高位患者最多，其次为髌骨外移，没有TT-TG距离异常者。 结论 与对照组相比，青少年髌骨不稳患者出现髌周脂肪垫水肿的概率增高，且髌骨高位因素占绝大部分。在进行膝关节MRI读片时，关注髌周脂肪垫的状态将对髌骨不稳的早期诊断及临床治疗提供帮助。
Abstract
Objective To measure the imaging parameters related to patellar instability based on knee MRI images of teenagers, comparatively analyze the morphological and signal changes of peripatellar fat pads on MRI between teenagers with patellar instability and those with normal patellofemoral joint relationships. This study aims to explore the diagnostic significance of MRI abnormal signs of peripatellar fat pads for patellar instability in teenagers and provide references for early diagnosis. Methods All subjects of this study were selected from teenagers aged 10-17 years who underwent knee MRI examinations at the Second Hospital of Ningbo from October 2020 to October 2023. After inclusion and exclusion criteria were applied, imaging parameters related to patellar instability were measured. The subjects were divided into a case group and a control group. The number of peripatellar fat pad edema cases in both groups was counted, and data analysis was performed using statistical software SPSS 20 (IBM Corp) and R4.1.2. Results Among 340 knee MRI examinations, 162 cases, 204 cases, and 106 cases presented with infrapatellar fat pad edema, suprapatellar fat pad edema, and anterior femoral fat pad edema, respectively，respectively. There were no significant differences in age, gender, side and chief complaints between the case group and the control group (P>0.05). The incidence of peripatellar fat pad edema in the case group was significantly higher than that in the control group (P<0.05), and the proportion of multifocal edema in the case group was significantly higher than that in the control group (35.00% vs 11.11%, P<0.001). In the case group, the majority of patients had patella alta, followed by patellar lateral displacement, and no patient showed abnormal tibial tuberosity-trochlear groove (TT-TG) distances. Conclusions Compared with the control group, teenagers with patellar instability have a higher probability of developing peripatellar fat pad edema, and patella alta accounts for the vast majority of contributing factors in these patients. Paying attention to the status of peripatellar fat pads during knee MRI interpretation can assist in the early diagnosis and clinical treatment of patellar instability.
关键词
磁共振成像； /
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青少年； /
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髌骨不稳； /
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髌周脂肪垫
Key words
Magnetic resonance imaging; /
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Adolescent; /
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Patellar instability; /
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Peripatellar fat pads
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