【摘要】：目的: 探討膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞的解剖及滑膜皺襞綜合征的MRI表現(xiàn)，并與關(guān)節(jié)鏡進(jìn)行對照，為臨床提供形態(tài)及診斷依據(jù)。研究分析髕內(nèi)側(cè)滑膜皺襞的寬度值與滑膜皺襞綜合征的相關(guān)性及滑膜皺襞綜合征患者與正常對照組的髕內(nèi)側(cè)滑膜皺襞寬度有無差異性。通過探討膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞的存在與否、形態(tài)改變及發(fā)生率來評估膝關(guān)節(jié)MRI對髕內(nèi)側(cè)滑膜皺襞及其綜合征的診斷價值，從而為臨床診斷因膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞異常引起的疾病提供影像方面支持。 材料與方法: 收集2012年7月至2013年11月在泰山醫(yī)學(xué)院附屬醫(yī)院做膝關(guān)節(jié)MRI檢查794例794膝，其中169側(cè)膝同時行膝關(guān)節(jié)鏡手術(shù)。統(tǒng)計794側(cè)膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞的發(fā)生率，分析髕內(nèi)側(cè)滑膜皺襞的發(fā)生與性別、膝側(cè)的相關(guān)性；以關(guān)節(jié)鏡為標(biāo)準(zhǔn)，分析169側(cè)膝的髕內(nèi)側(cè)滑膜皺襞MRI檢查的敏感性、特異性、陽性預(yù)測值、陰性預(yù)測值；同期收集20例40側(cè)膝健康志愿者的MRI檢查作為正常對照組(40膝中20膝存在髕內(nèi)側(cè)滑膜皺襞，其中將存在髕內(nèi)側(cè)滑膜皺襞但無任何臨床征狀的情況視為正常)分析滑膜皺襞綜合征患者的皺襞寬度與健康志愿者皺襞寬度是否存在差異性。 結(jié)果: 1、膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞的MRI診斷的靈敏性為92.6%，，特異性94.6%，陽性預(yù)測值為95.7%，陰性預(yù)測值為90.9%。 2、MRI檢查的794膝中髕內(nèi)側(cè)滑膜皺襞的發(fā)生率為59.9%，且其發(fā)生與性別、左右膝側(cè)無關(guān)，關(guān)節(jié)鏡檢查的169膝中髕內(nèi)側(cè)滑膜皺襞綜合征的發(fā)生率為21.9%。 3、經(jīng)卡方檢驗，得P0.05，髕內(nèi)側(cè)滑膜皺襞的皺襞寬度與髕內(nèi)側(cè)滑膜皺襞綜合征的發(fā)生相關(guān)，皺襞的寬度越大，發(fā)病的可能性就越大，經(jīng)獨立樣本t檢驗，P0.05，髕內(nèi)側(cè)滑膜皺襞綜合征患者的皺襞寬度與健康志愿者的皺襞寬度存在差異性。 結(jié)論: 1、膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞的MRI診斷的準(zhǔn)確性很高，可以很好的為臨床提供有價值的形態(tài)學(xué)的信息。 2、本組實驗中髕內(nèi)側(cè)滑膜皺襞的發(fā)生率為59.9%，髕內(nèi)側(cè)滑膜皺襞綜合征的發(fā)生率為21.9%，與國內(nèi)外文獻(xiàn)報道的基本一致。 3、髕內(nèi)側(cè)滑膜皺襞的皺襞寬度值大小與髕內(nèi)側(cè)滑膜皺襞綜合征的發(fā)生是相關(guān)的，髕內(nèi)側(cè)滑膜皺襞綜合征患者與正常對照組的皺襞寬度之間存在差異性。MRI對髕內(nèi)側(cè)滑膜皺襞綜合征的診斷是有一定價值的，MRI上髕內(nèi)側(cè)滑膜皺襞寬度可作為診斷滑膜皺襞綜合征的一項參考指標(biāo)。
[Abstract]:Objective: to study the anatomy of medial patellar plica of knee joint and the MRI manifestations of synovial plica syndrome, and to provide the clinical appearance and diagnostic basis for arthroscopy. To study the correlation between the width of medial patellar plica and synovial plica syndrome and whether there is any difference in the width of medial patellar plica between the patients with synovial plica syndrome and the normal control group. To evaluate the diagnostic value of MRI in the diagnosis of medial patellar synovial fold and its syndrome by discussing the existence, morphological change and incidence of medial patellar synovial fold of knee joint. It provides imaging support for clinical diagnosis of diseases caused by abnormal medial synovial plica of knee joint. Materials and methods: from July 2012 to November 2013, 794 patients (794 knees) were examined by MRI in affiliated Hospital of Taishan Medical College. The incidence of medial synovial fold in 794 sides of knee joint was counted and the correlation between the occurrence of medial patellar synovial fold and sex and knee side was analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of medial patellar plica MRI in 169 knees were analyzed by arthroscopy. During the same period, 20 healthy volunteers with 40 knees were examined by MRI as the normal control group (20 of 40 knees had medial patellar synovial folds. The medial patellar plica but no clinical symptoms were regarded as normal. The difference between the plica width of the patients with synovial plica syndrome and that of the healthy volunteers was analyzed. Results: 1. The sensitivity and specificity of MRI in the diagnosis of medial patellar plica of knee joint was 92.62.The positive predictive value was 95.7 and the negative predictive value was 90.9. 2The incidence of medial patellar synovial fold in 794 knees examined by MRI was 59.9, and its occurrence was not related to sex. The incidence of medial patellar plica syndrome in 169 knees examined by arthroscopy was 21.9. The width of the plica of medial patellar synovial fold was related to the occurrence of medial patellar synovial fold syndrome. The larger the width of plica, the more likely the disease was. The width of plica in patients with medial patellar plica syndrome was different from that in healthy volunteers. Conclusion: 1. The MRI diagnostic accuracy of medial patellar plica of knee joint is very high, which can provide valuable morphological information for clinic. 2. The incidence of medial patellar synovial fold and medial patellar plica syndrome was 59.9 and 21.9respectively, which was consistent with the literature reported at home and abroad. 3. The width of the plica of the medial patellar synovial fold is related to the occurrence of the medial patellar plica syndrome. The width of plica in patients with medial patellar plica syndrome is different from that in normal control group. MRI is valuable in the diagnosis of medial patellar synovial fold syndrome. The width of medial synovial plica on MRI can be used as a reference index for diagnosis of synovial plica syndrome.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R686;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張洪濤;梅繼文;高霞;;膝關(guān)節(jié)滑膜皺襞綜合征診斷及關(guān)節(jié)鏡下治療效果分析(附31例報告)[J];吉林大學(xué)學(xué)報(醫(yī)學(xué)版);2010年05期

2 陳群;馮陽;;髕內(nèi)側(cè)滑膜皺襞綜合征的磁共振和關(guān)節(jié)鏡的診斷[J];河北醫(yī)學(xué);2010年01期

3 程ho;溫建民;林新曉;吳夏勃;孫永生;孫衛(wèi)東;蔣科衛(wèi);梁朝;;關(guān)節(jié)鏡結(jié)合手法治療膝關(guān)節(jié)滑膜皺襞綜合征臨床觀察[J];北京中醫(yī)藥大學(xué)學(xué)報;2010年02期

4 李景陽;;髕內(nèi)側(cè)滑膜皺襞綜合征治療方法分析[J];遼寧醫(yī)學(xué)院學(xué)報;2010年03期

5 王永明,史晨輝,孫吉華,董金波,李江華,李寬新,孫建華,何斌;關(guān)節(jié)鏡診治膝關(guān)節(jié)滑膜皺襞綜合征62例報告[J];農(nóng)墾醫(yī)學(xué);2000年04期

6 李寬新,史晨輝,王永明,李茂強(qiáng);膝關(guān)節(jié)滑膜皺襞綜合征臨床診治進(jìn)展[J];農(nóng)墾醫(yī)學(xué);2003年06期

7 喻忠斌;覃松;王凱;劉駿;車彪;李鵬斌;婁文杰;;膝關(guān)節(jié)髕內(nèi)側(cè)滑膜皺襞綜合征的關(guān)節(jié)鏡下的診治[J];中外醫(yī)療;2013年11期

8 楊金永;趙斌;于臺飛;馬艷紅;郝雯;;磁共振T2-mapping成像對膝關(guān)節(jié)早期骨關(guān)節(jié)炎的診斷價值[J];山東大學(xué)學(xué)報(醫(yī)學(xué)版);2010年05期

9 王大鵬;趙鐵軍;張洪美;;膝關(guān)節(jié)滑膜皺襞綜合征的關(guān)節(jié)鏡診斷與治療[J];中國中醫(yī)骨傷科雜志;2012年04期

10 宋衛(wèi)東;李德;劉尚禮;李衛(wèi)平;黃建榮;彭岳文;沈慧勇;林道賢;;膝關(guān)節(jié)內(nèi)側(cè)滑膜皺襞綜合征的關(guān)節(jié)鏡診治[J];中華關(guān)節(jié)外科雜志(電子版);2010年01期

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