| 王小龙,刘云鹏,华国军,等.国人髌股关节稳定性的 CT扫描参数判断[J].安徽医药,2019,23(10):1952-1955. |
| 国人髌股关节稳定性的 CT扫描参数判断 |
| Judgment of CT scan parameters of stability of patellofemoral joint in Chinese population |
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| DOI：10.3969/j.issn.1009?6469.2019.10.011 |
| 中文关键词: 髌骨脱位 髌股关节 体层摄影术， X线计算机 影像学参数 |
| 英文关键词: Patella dislocation Patellofemoral joint Tomography,X?ray computed Radiologic parameter |
| 基金项目:无锡市科技发展资金项目( CSE31N1618)；无锡市卫生计生委科研项目基金( Q201772) |
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| 中文摘要: |
| 目的对比分析中国人群中正常髌股关节与髌骨脱位病人之间的髌股关节 CT参数并评估这些参数在诊断髌股关节不稳中的价值。方法回顾性分析 2013年 1月至 2017年 12月因髌股关节脱位在解放军联勤保障部队第九〇四医院进行膝关节 CT扫描的 22例( 28侧)病例影像学资料作为髌骨脱位组，以同一时期因外伤于该院行 CT扫描的 32例( 32侧)单侧正常膝关节样本作为健康对照组，对比两组之间的股骨滑车深度、股骨滑车、髌骨以及髌股关节力线等参数，绘制受试者工作特征曲线(ROC曲线)以获得有统计学意义的参数，计算相应临界值，并判断相关参数的灵敏度和特异度。结果髌骨脱位组和健康对照组的平均股骨滑车深度分别为 3.2 mm和 4.4 mm，ROC曲线下面积为 0.834，其临界值为 4.2 mm，诊断髌骨脱位的灵敏度为 82%，特异度为 83%；髌骨偏移为 56.7％和 85.3％， ROC曲线下面积为 0.971，髌骨偏移 ≥85.3%时，诊断髌骨脱位的特异度为 100%，灵敏度为 92%；髌骨倾斜角为 7.6°和 20.8°，ROC曲线下面积为 0.963，当髌骨倾斜角＞ 13.5°时，诊断髌骨脱位的灵敏度为 100%，特异度为 91%；胫骨结节 ?滑车沟槽( TT?TG)距离分别为 14.9 mm和 21.2 mm，ROC曲线下面积为 0.903，临界值为 18.8 mm，灵敏度为 93%，特异度为 96%。结论滑车深度，髌骨偏移，髌骨倾斜和 TT?TG距离是影响中国人群髌股关节稳定性最重要的参数。对于青少年人群可以通过 CT扫描和相关参数的测量判断髌股关节的稳定性，为预测髌骨脱位提供定量依据，并为制定相应治疗计划提供参考。 |
| 英文摘要: |
| Objective To compare the CT parameters of patellofemoral joint between normal patellofemoral joint and patella dislo?cation in Chinese population，and to evaluate the value of these parameters in the diagnosis of patellofemoral instability. Methods We retrospectively analyzed the imaging data of 22 cases(28 sides)of knee joint CT scan in the 904th Hospital of Joint LogisticSupport Force of P.L.A.due to patellofemoral dislocation from January 2013 to December 2017 as the patellar dislocation group，and 32 cases(32 sides)of unilateral normal knee joint samples received CT scan in this hospital due to trauma during the same periodas the healthy control group.The femoral trochlear depth，femoral trochlear，humerus and patellofemoral joint force lines were com? pared between the two groups.The characteristic curve(ROC curve)is used to obtain statistically significant parameters，calculate the corresponding critical value，and judge the sensitivity and specificity of the relevant parameters.Results The mean trochlear depth in the patellar dislocation group and control group was 3.2 mm and 4.4 mm，respectively；the area under the ROC curve is 0.834，the cutoff value was 4.2 mm，the sensitivity and specificity of the diagnosis of patellar dislocation was 82% and 83%，respec? tively；patellar bisect offset was 56.7% and 85.3%，the area under the ROC curve was 0.971，cutoff value was 85.3%，sensitivityand specificity of the diagnosis of patellar dislocation were 92% and 100%，respectively.Lateral patellar tilt anglein was 7.6° and 20.8°，the area under the ROC curve is 0.963，when patellar tilt angle is greater than 13.5°，sensitivity and specificity of the diagno? sis of patellar dislocation were 100% and 91%，respectively.The tibial tuberosity?trochlear groove(TT?TG)distance was 14.9 mm and 21.2 mm，respectively.The area under the ROC curve is 0.903，cutoff value was 18.8 mm，sensitivity and specificity of the diag? nosis of patellar dislocation were 93% and 96%，respectively.Conclusions The trochlear depth，bisect offset，patella tilting，and TT ?TG distance were parameters that significantly contributed to patellar instability in Chinese population.Stability of patellofemoraljoint in young adults could be estimated by CT scanning and the related parameters measurement，which provides a quantitative ba? sis for predicting patellar dislocation and reference for the development of corresponding treatment plan. |
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