[1]顾志娟,何亮,激扬,等.基于MRI、关节镜下参数的列线图模型对膝关节前交叉韧带损伤的预测效能研究[J].陕西医学杂志,2025,54(9):1208-1212,1218.[doi:DOI:10.3969/j.issn.1000-7377.2025.09.009]
　GU Zhijuan,HE Liang,JI Yang,et al.Predictive efficacy of anomogram model based on MRI and arthroscopic parameters for ACL injury of knee joint[J].,2025,54(9):1208-1212,1218.[doi:DOI:10.3969/j.issn.1000-7377.2025.09.009]
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基于MRI、关节镜下参数的列线图模型对膝关节前交叉韧带损伤的预测效能研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年9期
页码:
1208-1212,1218
栏目:
临床研究
出版日期:
2025-09-05

文章信息/Info

Title:
Predictive efficacy of anomogram model based on MRI and arthroscopic parameters for ACL injury of knee joint
作者:
顾志娟1; 何亮1; 激扬1; 刘娜1; 闫龙2; 刘国庆3
（1.西安医学院第一附属医院影像科，陕西 西安 710077；2.延安市中医医院影像科，陕西 延安 716000；3.陕西省中医医院影像中心，陕西 西安 710003）
Author(s):
GU Zhijuan1; HE Liang1; JI Yang1; LIU Na1; YAN Long2; LIU Guoqing3
(1.Department of Imaging,the Frist Affiliated Hospital of Xi’an Medical University,Xi’an 710077,China;2.Department of Imaging,Yan’an Hospital of Traditional Chinese Medicine,Yan’an 716000,China;3.Image Center,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an 710003,China)
关键词:
前交叉韧带损伤; 膝关节; 核磁共振; 关节镜; 列线图模型; 预测效能
Keywords:
Anterior cruciate ligament injury; Knee joint; MRI; Arthroscopy; Nomogram model; Predictive efficacy
分类号:
R 686.5
DOI:
DOI:10.3969/j.issn.1000-7377.2025.09.009
文献标志码:
A
摘要:
目的：基于核磁共振（MRI）、关节镜下参数构建列线图模型，并分析其对膝关节前交叉韧带（ACL）损伤的预测效能。方法：选取膝关节ACL损伤患者50例为损伤组，选取同期健康体检人群50例为完好组，比较两组MRI及关节镜下参数，分析ACL损伤影响因素，构建ACL损伤列线图预测模型并进行验证。结果：损伤组髁间切迹宽度指数（NWI）、股骨外侧髁指数（LFCI）、高度与前后径比率（HAPR）、胫骨棘宽度（TSW）、胫骨棘-髁间切迹比率（TSNR）低于完好组，Blumensaat线倾角（BIA)、股骨外侧髁比率（LFCR）、胫骨外侧后倾角（LPTS）、胫骨内侧后倾角（MPTS）高于完好组（均P<0.05）。多因素Logistic回归分析显示，BIA、LPTS和MPTS是膝关节ACL损伤的独立危险因素，TSW是膝关节ACL损伤的独立保护因素(均P<0.05)。基于TSW、BIA、LPTS和MPTS构建列线图预测模型，验证结果表明该模型临床预测效能良好。结论：TSW、BIA、LPTS和MPTS是膝关节ACL损伤的影响因素，基于上述因素构建的列线图预测模型具有良好的临床预测效能。
Abstract:
Objective:To construct a nomogram model based on MRI and arthroscopic parameters,and analyze its predictive efficacy for anterior cruciate ligament (ACL) injury of the knee joint.Methods：A total of 50 patients with ACL injury in the knee joint were selected as the injury group,and 50 healthy individuals undergoing physical examination at the same time were selected as the intact group.The MRI and arthroscopic parameters of the two groups were compared,and the influencing factors of ACL injury were analyzed,and a nomogram prediction model for ACL injury was constructed and validated.Results:The intercondylar Notch Width Index (NWI),Lateral Femoral Condyle Index (LFCI),height to anteroposterior diameter ratio (HAPR),tibial spine width (TSW),and tibial spine to notch ratio (TSNR) in the injury group were lower than those in the intact group,and the Blumensaat’s line inclination angle (BIA),lateral femoral condyle ratio (LFCR),lateral posterior tibial slope (LPTS),and medial posterior tibial slope (MPTS) in the injury group were higher than those in the intact group (all P<0.05).Multivariate Logistic regression analysis showed that BIA,LPTS,and MPTS were independent risk factors for ACL injury of the knee joint,while TSW was an independent protective factor (all P<0.05).A nomogram prediction model based on TSW,BIA,LPTS,and MPTS was constructed,and the verification results indicated that the model had good clinical predictive efficacy.Conclusion:TSW,BIA,LPTS and MPTS are the influencing factors for ACL injury of the knee joint.The nomogram prediction model constructed based on these factors has good clinical predictive efficacy.

参考文献/References:

[1]EKDAHL M,ACEVEDO M,DOMINGUEZ C,et al.Knee examination under anesthesia:Development of a predictive score for partial anterior cruciate ligament tears[J].Knee Surg Relat Res,2018,30(3):255-260.
[2]张新强,冯会成.振动刺激促进前交叉韧带重建后本体感觉恢复机制研究进展[J].陕西医学杂志,2022,51(1):125-129.
[3]SANDERS T L,MARADIT KREMERS H,BRYAN A J,et al.Incidence of anterior cruciate ligament tears and reconstruction:A 21-year population-based study[J].Am J Sports Med,2016,44(6):1502-1507.
[4]马雄伟,雷宝,王燕,等.后路QLB联合鸡尾酒疗法在关节镜ACLR术后镇痛中的效果分析[J].中国基层医药,2024,31(9):1339-1345.
[5]BISCIOTTI G N,CHAMARI K,CENA E,et al.Anterior cruciate ligament injury risk factors in football[J].J Sports Med Phys Fitness,2019,59(10):1724.
[6]周颐,柏帆,刘笑言,等.共用前交叉韧带骨道技术:关节镜下前交叉韧带重建中修复外侧半月板后根部损伤[J].中国微创外科杂志,2022,22(2):119-125.
[7]KAEDING C C,LGER-ST-JEAN B,MAGNUSSEN R A.Epidemiology and diagnosis of anterior cruciate ligament injuries[J].Clin Sports Med,2017,36(1):1-8.
[8]JHA V,PANDIT A.Notch volume measured on MRI is better than 2-dimensional notch parameters for predicting noncontact anterior cruciate ligament injury in males[J].Arthroscopy,2021,37(5):1534-1543.
[9]ZHANG C,XIE G,FANG Z,et al.Assessment of relationship between three-dimensional femoral notch volume and anterior cruciate ligament injury in Chinese Han adults:A retrospective MRI study[J].Int Orthop,2019,43(5):1231-1237.
[10]KIZILGOZ V,SIVRIOGLU A K,AYDIN H,et al.The combined effect of body mass index and tibial slope angles on anterior cruciate ligament injury risk in male knees:A case-control study[J].Clin Med Insights Arthritis Musculoskelet Disord,2019,12:71498258.
[11]FAHIM S M,DHAWAN T,JAGADEESH N,et al.The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width,notch width index,notch shape—A randomized control study[J].J Clin Orthop Trauma,2021,17:5-10.
[12]GRASSI A,PIZZA N,ZAMBON B J,et al.Higher risk of contralateral anterior cruciate ligament (ACL) injury within 2 years after ACL reconstruction in under-18-year-old patients with steep tibial plateau slope[J].Knee Surg Sports Traumatol Arthrosc,2021,29(6):1690-1700.
[13]DE SOUSA FILHO P G T,MARQUES A C,PEREIRA L S,et al.Analysis of posterior tibial slope as risk factor to anterior cruciate ligament tear[J].Rev Bras Ortop,2021,56(1):47-52.
[14]LI R,YUAN X,FANG Z,et al.A decreased ratio of height of lateral femoral condyle to anteroposterior diameter is a risk factor for anterior cruciate ligament rupture[J].BMC Musculoskelet Disord,2020,21(1):402.
[15]HODEL S,KABELITZ M,TONDELLI T,et al.Introducing the lateral femoral condyle index as a risk factor for anterior cruciate ligament injury[J].Am J Sports Med,2019,47(10):2420-2426.
[16]PFEIFFER T R,BURNHAM J M,HUGHES J D,et al.An increased lateral femoral condyle ratio is a risk factor for anterior cruciate ligament injury[J].J Bone Joint Surg Am,2018,100(10):857-864.
[17]BOURAS T,FENNEMA P,BURKE S,et al.Stenotic intercondylar notch type is correlated with anterior cruciate ligament injury in female patients using magnetic resonance imaging[J].Knee Surg Sports Traumatol Arthrosc,2018,26(4):1252-1257.
[18]苏虹,黄永原,张鹏翼,等.不同频率电针对前交叉韧带损伤家兔脊髓组织突触相关蛋白及神经递质的影响[J].陕西中医,2023,44(12):1688-1692.
[19]康彦忠,李文龙.前交叉韧带损伤患者膝关节前交叉韧带重建术中采用股骨椭圆隧道技术的效果[J].检验医学与临床,2023,20(10):1364-1368.
[20]柏瑞,黄俊成,何小华,等.低剂量双能量CT诊断膝关节前交叉韧带损伤的临床对照分析[J].中国CT和MRI杂志,2022,20(10):157-159.
[21]张新强,冯会成.振动刺激促进前交叉韧带重建后本体感觉恢复机制研究进展[J].陕西医学杂志,2022,51(1):125-129.
[22]庞龙,王雪臣,李丁丁,等.伴内侧副韧带断裂的前交叉韧带损伤患者两种修复方式效果对比分析[J].临床误诊误治,2024,37(16):31-37.
[23]BASUKALA B,JOSHI A,PRADHAN I.The effect of the intercondylar notch shape and notch width index on anterior cruciate ligament injuries[J].J Nepal Health Res Counc,2020,17(4):532-536.
[24]唐传姬,陈思敏,李亮,等.低剂量双能量CT及MRI诊断前交叉韧带损伤的价值观察[J].中国CT和MRI杂志,2024,22(1):155-157.
[25]王佳伟,李硕,牛军杰,等.膝关节内外侧半月板前后角、前交叉韧带的MRI图像及其诊断价值[J].中国临床医学影像杂志,2024,35(8):581-584.
[26]代承忠,王浩东.膝关节交叉韧带损伤患者MRI影像特点及诊断价值分析[J].河北医学,2024,30(8):1358-1362.
[27]邓翔天,郑占乐,邵德成,等.关节镜下评估胫骨平台骨折合并半月板撕裂和交叉韧带损伤的临床研究[J].中华外科杂志,2021,59(6):464-469.
[28]张海宇,闫宇涛,张烁,等.膝关节前交叉韧带扭伤及慢性损伤的MRI定量分析及与关节镜的对照研究[J].实用放射学杂志,2024,40(4):609-612.

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备注/Memo

备注/Memo:
陕西省中医药管理局科研项目（SZY-NLTL-2022-016）
更新日期/Last Update: 2025-09-04