膝关节髌韧带迂曲征的影像学观察

A radiographic study on tortuous sign of patellar ligament in the knee

摘要:

[目的] 对髌韧带在矢状位 MRI 迂曲征进行相关测量和分析。[方法] 回顾性分析 40 例双侧膝关节 MRI 图像，40 例患者均表现为一侧髌韧带迂曲，另一侧髌韧带正常。在矢状面 MRI 测量髌韧带长度和髌骨长度；在横切面 MRI 图像上测量髌韧带近端、中部、远端的横截面积。比较两侧髌腱测量结果以及其他病理所见。[结果]髌韧带迂曲征发生在近端 1 例，占 2.50%；中段 2 例，占 5.00%；远端 27 例，占 67.50%；全段 10 例，占 25.00%。迂曲侧伴有膝关节积液 11 例，占 27.50%；伴前交叉韧带断裂 4 例，占 10.00%。影像测量方面，两侧髌骨长度比较差异无统计学意义(P＞0.05)，迂曲侧髌韧带长度显著短于健康侧 (P＜0.05)。迂曲侧近端横截面积、中段横截面积和远端横截面积均显著小于健康侧 (P＜0.05)。[结论] 髌韧带在 MRI 图像出现迂曲征是临床中常见的现象，与髌韧带退变有关，并伴随前交叉韧带断裂及关节积液。

Abstract:

[Objective] To measure and analyze the tortuous sign of patellar ligament on the sagittal MRI of the knee. [Methods] A ret- rospective study was conducted on MRI images of 40 bilateral knee. All 40 patients presented tortuosity of the patellar tendon on one side, whereas normal patellar ligament on the opposite side. The length of patellar ligament and patellar bone were measured by MRI in sagittal plane. The proximal, middle, and distal cross-sectional areas of the patellar ligament were measured on cross-sectional MRI images. The results of the two measurements of the patellar tendon and other pathological findings were compared. [Results] The tortuosity of the patel- lar ligament was seen in the proximal end in 1 case, accounting for 2.50%, the middle section in 2 cases, accounting for 5.00%, the distal end in 27 cases, accounting for 67.50%, while involved the whole section in 10 cases, accounting for 25.00%. Tortuous side was accompa- nied with intraarticular effusion in 11 cases, accounting for 27.50%, and anterior cruciate ligament tear in 4 cases, accounting for 10.00%. In terms of image measurement, there was no significant difference in the patellar length between the two sides (P＞0.05) , however, the tor- tuous side proved significantly shorter length of patellar ligament than the healthy side (P＜0.05) . In addition, the tortuous side had signifi- cantly smaller areas at the proximal, middle and distal cross sections than the healthy side (P＜0.05) . [Conclusion] Tortuosity of the patel- lar ligament on MRI image is a common clinical phenomenon, which is related to the degeneration of the patellar ligament, might be accom- panied by anterior cruciate ligament rupture and intraarticular effusion.