Shen Ji, Qin Le, Yao Wei-Wu, Li Mei
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China.
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China.
Exp Ther Med. 2017 Dec;14(6):5438-5444. doi: 10.3892/etm.2017.5217. Epub 2017 Sep 27.
The clinical diagnosis of femoral trochlear dysplasia primarily relies on imaging. In the past, plain imaging was the major source of diagnosis. The present study investigated the application of magnetic resonance imaging (MRI) in the objective assessment of severe femoral trochlear dysplasia. A retrospective analysis was performed on knee MRIs from 30 normal subjects (30 knees) and 59 patients (61 knees) with severe femoral trochlear dysplasia based on the Dejour morphological classification. Cartilage and subchondral bone landmarks were used to compare a series of measurements between patient and control groups. These measurements included the femoral trochlear groove depth, sulcus angle, the lateral trochlear inclination, trochlear facet asymmetry, the femoral medial and lateral condyle symmetry, and the ratios between the femoral medial/lateral condyles and the maximal trochlear width. The measurement values based on the two types of landmarks were also compared within the patient and control groups, separately. In addition, the femoral trochlear groove depth, sulcus angle, lateral trochlear inclination and trochlear facet asymmetry of patients with different Dejour types were compared. Significant differences were observed in the femoral trochlear groove depth, sulcus angle, lateral trochlear inclination and trochlear facet asymmetry between the patient and control groups (P<0.05). Based on the two types of landmark, all indexes were significantly different (P<0.05; with the exception of lateral trochlear inclination) between the patient and control groups. Among patients with various Dejour types, the femoral trochlear groove depth, sulcus angle, lateral trochlear inclination and trochlear facet asymmetry demonstrated no significant differences. MRI exhibited advantages in revealing articular cartilage over conventional radiography and computed tomography. Therefore, cartilage landmarks in MRI images may be utilized to objectively evaluate femoral trochlear dysplasia in patients with severe femoral trochlear dysplasia.
股骨滑车发育不良的临床诊断主要依靠影像学检查。过去，X线平片是主要的诊断手段。本研究探讨了磁共振成像（MRI）在严重股骨滑车发育不良客观评估中的应用。基于Dejour形态学分类，对30例正常受试者（30个膝关节）和59例严重股骨滑车发育不良患者（61个膝关节）的膝关节MRI进行回顾性分析。利用软骨和软骨下骨标志点比较患者组和对照组之间的一系列测量值。这些测量值包括股骨滑车沟深度、沟角、外侧滑车倾斜度、滑车小面不对称性、股骨内外侧髁对称性以及股骨内外侧髁与最大滑车宽度的比值。还分别在患者组和对照组内比较基于两种标志点的测量值。此外，比较了不同Dejour类型患者的股骨滑车沟深度、沟角、外侧滑车倾斜度和滑车小面不对称性。患者组和对照组之间在股骨滑车沟深度、沟角、外侧滑车倾斜度和滑车小面不对称性方面存在显著差异（P<0.05）。基于两种标志点，患者组和对照组之间所有指标均有显著差异（P<0.05；外侧滑车倾斜度除外）。在不同Dejour类型的患者中，股骨滑车沟深度、沟角、外侧滑车倾斜度和滑车小面不对称性无显著差异。与传统X线摄影和计算机断层扫描相比，MRI在显示关节软骨方面具有优势。因此，MRI图像中的软骨标志点可用于客观评估严重股骨滑车发育不良患者的股骨滑车发育不良情况。
