【摘要】 目的:比较CT与MRI测量内翻性膝骨关节炎股骨后髁角(posterior condylar angle,PCA)的差异。方法:回顾性分析2018年11月—2020年2月在南京医科大学第一附属医院骨关节外科行全膝关节置换术的71例患者(73例内翻骨关节炎膝关节)的全下肢CT及膝关节MRI资料。分别使用CT及MRI图像对PCA进行测量,采用MRI图像测量股骨内外后髁及股骨远端内外髁软骨厚度。同时测量标本股骨内外侧后髁软骨厚度,将测量结果进行比较及相关性分析。结果:根据CT图像测量的PCA[(4.09±1.39)°]显著大于MRI测量的PCA[(2.25±1.01)°](P<0.01)。标本上股骨内侧后髁软骨厚度[(1.9±0.6)mm]与标本上股骨外侧后髁软骨厚度[(2.8±0.6)mm],MRI测量股骨内侧后髁的软骨厚度[(1.9±0.6)mm]与MRI测量股骨外侧后髁的软骨厚度[(2.8±0.5)mm],MRI测量股骨远端内侧髁软骨厚度[(1.3±0.4)mm]与MRI测量股骨远端外侧髁软骨厚度[(2.5±0.4)mm]之间,差异均具有统计学意义(P<0.01)。而标本股骨内外侧后髁软骨厚度与MRI测量值之间差异无统计学意义(P>0.05)。Pearson相关性分析结果显示,股骨外侧后髁软骨与股骨内侧后髁软骨厚度相差2 mm,CT测量PCA将比MRI测量PCA大接近3°。结论:内翻性膝骨关节炎普遍存在股骨内侧后髁软骨的磨损,并对依据股骨后髁线确定的股骨假体旋转产生显著影响。MRI与CT的术前测量存在显著差异,关节外科医生在制定术前计划时必须把这种差异考虑在内。更多还原

【Abstract】 Objective:This study aims to compare the differences between CT measured and MRI measured femoral posterior condylar angle(PCA)in varus osteoarthritis knees. Methods:The CT data of lower-extremity and MRI data of involved knees in 71 patients(73 varus osteoarthritis knees)who underwent primary TKA at department of orthopedic surgery,Jiangsu Province Hospital from November 2018 to February 2020 were retrospected in our study. The CT and MRI images were used to measure PCA respectively. MRI images were also used to measure the cartilage thickness of femoral posterior condyles and distal femoral condyles.At the same time,the thickness of femoral posterior condylar cartilage of specimens was also measured. The measurement results were compared and analyzed for correlation. Results:The PCA-CT(4.09 ± 1.39)°was significant larger than PCA-MRI(2.25 ± 1.01)°(P <0.01). The MRI measured cartilage thickness of medial posterior condyle(1.9 ± 0.6)mm and cartilage thickness of lateral posterior condyle(2.8 ± 0.5)mm,MRI measured cartilage thickness of medial distal femoral condyle(1.3 ± 0.4)mm and cartilage thickness of lateral distal femoral condyle(2.5 ± 0.4)mm,cartilage thickness of medial posterior condyle of specimens(1.9 ± 0.6)mm and cartilage thickness of lateral posterior condyle of specimens(2.8 ± 0.6)mm all presented significant difference between each other(P<0.01).But there was no statistical difference between the cartilage thickness of medial and lateral posterior condyles measured by MRI and that measured on the specimens(P>0.05).Also,Pearson correlation analysis results showed that:if 2 mm cartilage thickness difference exists between medial and lateral posterior condyle,almost 3° external malrotation was found between PCA-CT and PCA-MRI.Conclusion:Cartilage wear of medial posterior condyle commonly occurs in varus knee osteoarthritis and this has an impact on the rotational alignment of femoral component. Significant differences exist in preoperative measurements of MRI and CT,and orthrpedic surgeons must take these differences into consideration when making preoperative planning.更多还原