上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

前交叉韧带重建术后评价的CT和磁共振成像比较研究

杨献峰1，王冬梅1，陈东阳2，朱 斌1，蒋 青2   

  1. 南京大学医学院附属鼓楼医院 1.放射科， 2.骨科， 南京 210008
  • 出版日期:2014-11-28 发布日期:2014-12-02
  • 作者简介:杨献峰（1980—），男，主治医师，博士生; 电子信箱: xianfeng9807@163.com。

Comparative study of CT and magnetic resonance imaging for postoperative evaluation of anterior cruciate ligament reconstruction

YANG Xian-feng1, WANG Dong-mei1, CHEN Dong-yang2, ZHU Bin1, JIANG Qing2   

  1. 1.Department of Radiology， 2.Department of Orthopedics， the Affiliated Drum Tower Hospital of Nanjing University Medical School， Nanjing 210008, China
  • Online:2014-11-28 Published:2014-12-02

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摘要：

目的 比较CT和磁共振成像（MRI）在前交叉韧带（ACL）重建术后评价中的应用价值，探讨CT与MRI新技术的临床应用。方法 15例自体肌腱前交叉韧带重建术后患者均接受螺旋CT容积扫描、常规MRI和MR扩散张量成像，对移植物及周围结构进行观察，由1名放射科医师和1名骨科医师对两种评价方式进行评分。结果 CT曲面重建技术能够清晰、直观地显示骨隧道及固定螺钉的形态及界面情况，多平面重组技术有助于显示移植物轮廓、髁间窝骨赘形成情况，容积再现技术可任意角度显示隧道内口与髁间嵴的关系。MRI可清晰显示移植物纤维束，并可提供量化数据。移植物连续性及密度/信号均匀度CT评分低于MRI （P=0.001），隧道口位置、螺钉及髁间窝形态CT评分高于MRI （P=0.001），隧道周围骨密度CT评分高于MRI （P=0.001），关节腔及周围结构MRI评分高于CT （P=0.001），CT与MRI骨隧道宽度测量评分的差异无统计学意义（P=0.102）。结论 CT三维重建技术在观察骨隧道开口位置、测量隧道内径、评价周围骨质情况方面优于MRI，而MRI对移植物的形态和内部病理改变更为敏感。CT和MRI的新技术使ACL重建术后评价更为直观和客观。

关键词: 前交叉韧带, 重建, CT, 磁共振成像, 比较

Abstract:

Objective To compare the application value of CT and magnetic resonance imaging (MRI) in the postoperative evaluation of anterior cruciate ligament (ACL) reconstruction and to explore the clinical application of new imaging technologies. Methods Fifteen patients who underwent ACL reconstruction by the autologous tendon were scanned by spiral CT, routine MRI, and MR diffusion tensor imaging. The grafts and surrounding structures were observed and scored by two evaluation methods by one radiologist and one orthopedist. Results The bone tunnel, screw, and interface were clearly and directly displayed by CT curve planar reconstruction. The multiple planar reconstruction was helpful for displaying the contour of the graft and the osterophyte of the inter-condylar notch. The volume render technique could display the relationship of tunnel aperture and intercondylar eminence at any angle. MRI clearly displayed the fiber bundle of graft and provided quantitative data. Scores of the continuity and density/signal uniformity of graft and articular cavity and surrounding structure of CT were lower than those of MRI (P=0.001). Scores of the position of tunnel aperture, screw, shape of inter-condylar notch, and surrounding bone mineral density of CT were higher than those of MRI (P=0.001). The difference of scores of bone tunnel diameter measurements of CT and MRI was not statistically significant (P=0.102). Conclusion CT 3D reconstruction technology is better than MRI for observing the position of tunnel aperture, measuring the internal diameter of tunnel, and evaluating surrounding bone mineral density, while MRI is more sensitive to the shape and internal pathological changes of the graft. The postoperative evaluation of ACL reconstruction can be more straightforward and objective by CT and MRI.

Key words: anterior cruciate ligament, reconstruction, CT, magnetic resonance imaging, comparison