前交叉韧带重建术后MRI评分与临床膝关节主、客观功能评分的对比研究

doi:10.13418/j.issn.1001-165x.2016.06.016

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (6): 677-684.doi: 10.13418/j.issn.1001-165x.2016.06.016

前交叉韧带重建术后MRI评分与临床膝关节主、客观功能评分的对比研究

吴冰^1,2，　陆伟^1,2，　王大平^1,2，　柳海峰^1,2，　朱伟民^1,2，　欧阳侃^1,2，　李顶夫³，　李盛⁴

1.深圳大学第一附属医院（深圳市第二人民医院）运动医学科，深圳 518000； 2.深圳市数字骨科技术工程实验室，深圳 518000； 3.深圳大学第一附属医院（深圳市第二人民医院）放射科，深圳 518000； 4.深圳大学, 深圳 518060

收稿日期:2016-02-22 出版日期:2016-11-25 发布日期:2016-12-20
通讯作者: 陆伟,教授，主任医师, E-mail: winerl@sina.com;王大平,教授，主任医师, E-mail: dapingwang@medmail.com.cn
作者简介:吴冰（1989-），男，湖南人，研究方向：运动医学，E-mail:cdtywubing@163.com
基金资助:
广东省科技计划项目 (2014A020212656，2015 A030401017)；深圳市科技研发计划项目 (JCYJ20140414170 821213，JCYJ20140414170821157)

A comparative study of a MRI scoring system with traditional outcome evaluation after anterior cruciate ligament reconstruction

WU Bing^1,2, LU Wei ^1,2, WANG Da-ping ^1,2, LIU Hai-feng ^1,2, ZHU Wei-min ^1,2, OU Yang-kan^1,2, LIDing-fu³, LI Sheng⁴

1. Department of Sports Medical, Shenzhen First Affiliated Hospital, Shenzhen University, Shenzhen 518000, China; 2. Shenzhen Digital Orthopaedic Engineering Laboratory, Shenzhen 518000, China; 3.Department of Radiology, Shenzhen First Affiliated Hospital, Shenzhen University, Shenzhen 518000, China; 4. Shenzhen University, Shenzhen 518060, China

Received:2016-02-22 Online:2016-11-25 Published:2016-12-20
Contact: LU Wei, E-mail:winerl@sina.com; WANG Da-ping, E-mail:dapingwang @medmail.com

摘要/Abstract

摘要：

目的　研究利用MRI进行前交叉韧带（anterior cruciate ligament，ACL）重建术后移植物评分的方法，并探讨MRI评分结果与临床膝关节主、客观功能评分结果的相关性，为临床ACL移植物评估提供参考方法。方法　追踪54例关节镜下ACL单束重建病例，计算MRI上ACL移植物容量（graft volume）、张力（graft tension）、信号强度（signal intensity ，SI)作为评估依据进行移植物MRI评分,同时计算MRI评分与膝关节主观功能评分（IKDC评分）、客观功能评分（KT2000）的相关性。结果　54例患者平均随访时间(18.3±4.3)月。平均ACL移植物MRI评分及膝关节主、客观功能评分分别为75.19±7.20、85.12±9.45、83.07±12.63。MRI评分结果与膝关节主、客观功能评分结果呈正性线性相关，相关系数有统计学意义（r=0.696, P=0.001；r=0.767, P=0.000）；根据MRI评分（X）及临床膝关节主、客观功能评分（Y）拟合出的回归方程具有统计学意义（P<0.01），MRI评分可以预测膝关节主、客观功能评分（R2=0.485；R2=0.589）。结论　MRI评分可作为一种新工具，补充和完善目前ACL重建术后评判体系，从而有助于更合理地评判ACL移植物愈合情况，进一步指导康复锻炼方案的制定。

关键词: 前交叉韧带, 临床评估, 核磁共振影像, 功能评分

Abstract:

Objective　To investigate an appropriate method of magnetic resonance imaging (MRI)scoring system to assess anterior cruciate ligament (ACL ) graft health at different time after ACL reconstruction, and to determineif the MRI scoring results correlate with commonlyused clinicalknee joint function outcome evaluation results.　Methods　Based on a subset of 54 participants enrolled in an ongoing single bundle ACL reconstruction clinical trial, AP knee laxity, IKDC and a MRI scoring system based on graft volume,signal intensity (SI) and graft tension were assessed during the follow-up, and then correlation of MRI scoring results and traditional clinical knee joint function results were determined using the linear correlation and linear regression statistical methods in SPSS software.　Results　All the 54 patients were followed up with a mean follow-up period of 18.3±4.3 months. The average score of AP knee laxity, IKDC and MRI assessment were 85.12±9.45, 83.07±12.63, 75.19±7.20 respectively. MRI scoring results and clinical knee joint function scoring had positively linear correlation, and the correlation coefficient was statistically significant (r=0.696, P=0.001; r=0.767,P=0.000). The regression equationfitted according to the MRI score (X) and clinical knee joint function of subjective and objective score was statistically significant (P<0.01). MRI scoring can predict traditional clinical knee joint function of subjective and objective results.　Conclusions　Just as subjective and objective scoring of traditional clinical knee joint function , the MRI scoring system can also be used to assess outcomes of ACL reconstruction,thus supplementing and improving current clinical evaluation methods for ACL graft health and laying a foundation for a more scientific postoperative evaluation system of ACL graft healing process.

Key words: Anterior cruciate ligament, Clinical assessment, Magnetic resonance imaging (MRI), Function scores

吴冰,陆伟,王大平,柳海峰,朱伟民,欧阳侃,李顶夫,李盛. 前交叉韧带重建术后MRI评分与临床膝关节主、客观功能评分的对比研究[J]. 中国临床解剖学杂志, 2016, 34(6): 677-684.

WU Bing, LU Wei, WANG Da-ping, LIU Hai-feng, ZHU Wei-min, OU Yang-kan, LIDing-fu, LI Sheng. A comparative study of a MRI scoring system with traditional outcome evaluation after anterior cruciate ligament reconstruction[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(6): 677-684.

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前交叉韧带重建术后MRI评分与临床膝关节主、客观功能评分的对比研究

A comparative study of a MRI scoring system with traditional outcome evaluation after anterior cruciate ligament reconstruction

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