Nishida Yusuke, Nishino Tomofumi, Tanaka Kenta, Onishi Shinzo, Kanamori Akihiro, Yamazaki Masashi
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.
Sports Medical Clinic, Japan Institute of Sport Sciences, Tokyo 115-0056, Japan.
J Clin Med. 2021 Sep 10;10(18):4092. doi: 10.3390/jcm10184092.
Ultrasonography and MRI are used for imaging evaluation of patellar tendinopathy, and "thickening of the tendon" is known as one of the characteristic findings. However, there are no evidence-based quantitative criteria to help evaluate this phenomenon. The purpose of this study was to investigate an objective measure of patellar tendon thickness. Patellar tendon thickness was evaluated in 65 elite university athletes using both ultrasonography and MRI. The relationship between tendon thickness and clinical patellar tendinopathy was investigated, and the cutoff value of the tendon thickness was calculated. Of the 129 knees included in the analysis, clinical patellar tendinopathy was found in 16 knees (12.4%). The proximal patellar tendon was significantly thicker in athletes with clinical patellar tendinopathy on both ultrasonography (8.3 mm vs. 5.1 mm; < 0.001) and MRI (9.9 mm vs. 5.5 mm; < 0.001). Setting the cutoff value to a thickness of >7.0 mm was an accurate predictor of clinical patellar tendinopathy (ultrasonography: sensitivity 81.3%, specificity 95.6%; MRI: sensitivity 100%, specificity 89.4%). Both ultrasonography and MRI measurement of the proximal patellar tendon thickness reflected the presence of clinical patellar tendinopathy. Defining "thickening of the patellar tendon" as thicker than 7.0 mm on both ultrasonography and MRI therefore has clinical significance.
超声检查和磁共振成像（MRI）用于髌腱病的影像学评估，“肌腱增厚”是其特征性表现之一。然而，目前尚无基于证据的定量标准来辅助评估这一现象。本研究的目的是探究髌腱厚度的客观测量方法。使用超声检查和MRI对65名精英大学运动员的髌腱厚度进行评估。研究了肌腱厚度与临床髌腱病之间的关系，并计算了肌腱厚度的临界值。在纳入分析的129个膝关节中，16个膝关节（12.4%）发现有临床髌腱病。在超声检查（8.3毫米对5.1毫米；<0.001）和MRI（9.9毫米对5.5毫米；<0.001）中，患有临床髌腱病的运动员的髌腱近端明显更厚。将临界值设定为厚度>7.0毫米是临床髌腱病的准确预测指标（超声检查：敏感性81.3%，特异性95.6%；MRI：敏感性100%，特异性89.4%）。超声检查和MRI对髌腱近端厚度的测量均反映了临床髌腱病的存在。因此，将超声检查和MRI上的“髌腱增厚”定义为厚度大于7.0毫米具有临床意义。
