膝关节前交叉韧带重建术后进行MRI-3D扫描的可行性

【摘要】 目的：分析膝關节前交叉韧带（ACL）重建术后进行MRI-3D扫描的可行性。方法：回顾性分析2015年1-12月膝关节ACL损伤患者24例的临床资料，均行ACL重建术。均于术后12个月，进行MRI-2D和MRI-3D检查，比较患者手术前后的Lysholm评分、KT-1000测量的胫骨相对前移距离，比较患者MRI-2D和MRI-3D重建图像上Blumensaat角。结果：术后12个月膝关节Lysholm评分高于术前，且KT-1000测量结果小于术前，比较差异均有统计学意义（P<0.05）;MRI-3D和MRI-2D测量的患侧Blumensaat角比较差异有统计学意义（P<0.05），健侧Blumensaat角比较差异无统计学意义（P>0.05），且MRI-3D患侧与健侧Blumensaat角比较差异无统计学意义（P>0.05），而MRI-2D患侧与健侧Blumensaat角比较差异有统计学意义（P<0.05）。结论：MRI-3D较MRI-2D更有利于准确测量Blumensaat角，且ACL重建术后膝关节MRI-3D扫描可常规做术后复查的参考，有助于指导术中定位及术后评估。

【关键词】 前交叉韧带; 磁共振成像; 三维重建

【Abstract】 Objective：To analyze the feasibility of MRI-3D scan after anterior cruciate ligament（ACL）reconstruction of knee joint.Method：The clinical data of 24 patients with ACL injury of knee joint from January to December 2015 were retrospectively analyzed，all patients underwent ACL reconstruction.And all patients underwent MRI-2D and MRI-3D examinations 12 months after operation，the Lysholm score and the relative forward distance of tibia measured by KT-1000 before and after operation were compared，the Blumensaat angles on the reconstructed images of patients between MRI-2D and MRI-3D were compared.Result：The Lysholm score of knee joint after operation 12 months was higher than that of before operation，and the KT-1000 measurement results were lower than that of before operation，the differences were statistically significant（P<0.05）.The Blumensaat angles measured by MRI-3D and MRI-2D was compared，the difference was statistically significant（P<0.05），and the Blumensaat angle of the contralateral side was compared，the difference was not statistically significant（P>0.05）.The Blumensaat angle between the affected side and the healthy side in MRI-3D was compared，the difference was not statistically significant（P>0.05），the Blumensaat angle between the affected side and the healthy side in MRI-2D was compared，the difference was statistically significant（P<0.05）.Conclusion：Compared with MRI-2D，MRI-3D is more advantageous for accurate measurement of Blumensaat angle，and MRI-3D scan of knee joint after ACL reconstruction can be used as a routine reference for post-operative review，which is helpful for guiding intraoperative localization and post-operative evaluation.

【Key words】 Anterior cruciate ligament; Magnetic resonance imaging; Three-dimensional reconstruction

First-author’s address：Guigang People’s Hospital，Guigang 537100，China

doi：10.3969/j.issn.1674-4985.2019.03.003