前交叉韧带弥散张量纤维示踪成像观测及临床应用

doi:10.13418/j.issn.1001-165x.2021.04.008

摘要/Abstract

摘要： 目的　为前交叉韧带损伤程度的分级诊断提供影像学数据。方法　选取新乡医学院附属医院膝关节弥散张量成像扫描检查的正常者100例和单侧前交叉韧带撕裂伤患者100例，按照损伤程度分为Ⅰ~Ⅳ级，在工作站划分前交叉韧带不同部位及损伤处的感兴趣区，生成纤维示踪图像，测量感兴趣区的各向异性分数（fractional anisotropy，FA）和表观弥散系数（apparent diffusion coefficient，ADC）。比较前交叉韧带不同部位及不同程度损伤处的FA和ADC数值。结果　前交叉韧带上端、上中部、中部、下中部、下端的FA值和ADC值差异有统计学意义（P<0.05），FA随前交叉韧带部位自上而下逐渐降低呈负相关，ADC则逐渐增高呈正相关；组间比较，上端与上中部FA值和ADC值差异无统计学意义（P>0.05），其他部位之间FA值和ADC值差异均有统计学意义（P<0.05）。前交叉韧带Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级损伤处FA值和ADC值差异有统计学意义（P<0.05），FA随损伤程度增高而逐渐降低，ADC则逐渐增高；组间比较，Ⅰ级与Ⅱ级FA值和ADC值差异无统计学意义（P>0.05），其他损伤分级之间FA值和ADC值差异均有统计学意义（P<0.05）。结论　前交叉韧带的FA和ADC与部位、损伤程度等密切相关，弥散张量纤维示踪成像为前交叉韧带损伤的微细结构变化提供了客观影像诊断依据。

关键词: 前交叉韧带, 　弥散张量纤维示踪成像, 　前交叉韧带损伤, 　弥散张量成像, 　MRI

Abstract: Objective　To provide image data for grading diagnosis in the different degree of anterior cruciate ligament injury. Methods One hundred normal knee joint and one hundred unilateral anterior cruciate ligament laceration in the Affiliated Hospital of Xinxiang Medical University were selected by diffusion tensor imaging scanning, and divided into I grade, Ⅱ grade, Ⅲ grade and Ⅳ grade according to the damage degree. At the workstation, the regions of interest of the anterior cruciate ligament and its injury were divided, the tractography images were generated and the fractional anisotropy (FA) values and apparent diffusion coefficient (ADC) values of the regions of interest were measured. The FA values and ADC values were compared in different position and different degree damage position of the anterior cruciate ligament. Results There were significant differences in the FA values and ADC values of the anterior cruciate ligament among the upper ends, upper-middle position, middle position, lower-middle position and lower ends (P<0.05), the FA values was negatively correlated with the decreasing of anterior cruciate ligament from top to bottom, while the ADC values was positively correlated with the increasing of anterior cruciate ligament. There was no significant difference in the FA values and ADC values between the upper ends and upper-middle position of the groups (P>0.05), and it was significant difference in the FA values and ADC values between the other position (P<0.05). There were significant differences in the FA values and ADC values of the anterior cruciate ligament injure at I grade, II grade, III grade and IV grade (P<0.05), the FA values decreased with the increasing of damage degree, while the ADC values increased. There was no significant difference in the FA values and ADC values between the I grade and II grade (P>0.05), and it was significant differences in the FA values and ADC values between the other damage grades (P<0.05). Conclusions The FA values and ADC values of anterior cruciate ligament are closely related to the damage location and damage degree. Diffusion tensor tractography imaging can provide an objective imaging diagnosis basis for the changes of the microstructure of anterior cruciate ligament injury.

Key words: Anterior cruciate ligament, 　Diffusion tensor tractography imaging, 　Anterior cruciate ligament injury, 　Diffusion tensor imaging, 　Magnetic resonance imaging

中图分类号:

R322
R445.2

王长青, 杨荣丽, 付升旗. 前交叉韧带弥散张量纤维示踪成像观测及临床应用[J]. 中国临床解剖学杂志, 2021, 39(4): 405-409.

Wang Changqing, Yang Rongli, Fu Shengqi. Diffusion tensor tractography imaging observation and clinical application of the anterior cruciate ligament[J]. Chinese Journal of Clinical Anatomy, 2021, 39(4): 405-409.

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