磁共振分析成人膝关节外侧盘状半月板状态与关节软骨厚度间的关系

The Relationship between the Status of Lateral Meniscus and Articular Cartilage Thickness in Adult Knee Joints Assessed by Magnetic Resonance Imaging

摘要: 目的：运用核磁共振技术(MRI)观察完全型外侧盘状半月板(complete discoid lateral meniscus, CDLM)与正常半月板之间的各区域软骨厚度的影像学测量差异，评估关节软骨厚度与盘状半月板之间是否存在关系。方法：收集2023年2月至2024年8月在安徽医科大学第一附属医院运动创伤与关节镜外科就诊的患者资料，选取符合条件的120例患者，其中男43例，女77例，年龄19~55岁，平均年龄33.80 ± 9.03岁。研究对象包括40例已发生破裂的盘状半月板患者、40例未发生破裂的盘状半月板患者以及40例拥有正常形态和完整结构的外侧半月板的志愿者作为对照组。所有人群均在同一医院使用相同设备接受膝关节MRI检查，通过RadiAntViewer软件解析并测量患者的磁共振影像学资料，由两名骨科医生及一名放射科医生在膝关节MRI的矢状面层面上分别分次测量每位患者股骨外侧髁、股骨内侧髁以及内侧胫骨平台、外侧胫骨平台等12个区域的关节软骨厚度，比较研究组和对照组之间的差异。结果：1. 在股骨外侧髁中间软骨、股骨外侧髁后方软骨、外侧胫骨平台前方软骨、外侧胫骨平台中间软骨、外侧胫骨平台后方软骨这五个测量点中，三组患者的数值间差异具有统计学意义(P < 0.05)；2. 股骨外侧髁前方软骨、股骨内侧髁软骨、内侧胫骨平台软骨等测量值之间未见统计学差异(P > 0.05)；3. 三组患者差异测量点数据的组间两两比较发现：在正常半月板对照组分别与完整盘状半月板组、破裂盘状半月板组的比较中，上述五个差异显著的测量点均存在统计学差异(P < 0.05)，在完整盘状半月板组与破裂盘状半月板组的比较中，这五个测量点均未见统计学差异(P > 0.05)。结论：基于MRI观测发现，盘状半月板会影响股骨外侧髁负重面及外侧胫骨平台的软骨厚度，这种影响来源于盘状半月板本身，即盘状半月板无论是否破裂均会影响以上区域的软骨厚度。

Abstract: Objective: Use Magnetic Resonance Imaging (MRI) to observe the differences in cartilage thickness measurements in various regions between complete discoid lateral meniscus (CDLM) and normal meniscus, and to evaluate whether there is a relationship between articular cartilage thickness and discoid meniscus. Methods: We collected data from patients who visited the Department of Orthopaedic Sports Trauma and Arthroscopic Surgery at the First Affiliated Hospital of Anhui Medical University from February 2023 to August 2024. The total of 120 eligible patients were selected, including 43 males and 77 females, with ages ranging from 19 to 55 years old, and an average age of 33.80 ± 9.03 years. The study population included 40 patients with ruptured discoid meniscus, 40 patients with intact discoid meniscus, and 40 volunteers with normal morphology and intact structure of the lateral meniscus as the control group. All subjects underwent knee MRI examination using the same equipment at the same hospital. The MRI images were analyzed and measured using RadiAntViewer software. Two orthopedic surgeons and one radiologist independently measured the articular cartilage thickness in 12 regions, including the lateral femoral condyle, medial femoral condyle, medial tibial plateau, and lateral tibial plateau, on the sagittal plane of the knee MRI for each patient. The differences between the study group and the control group were compared. Results: 1. Significant differences were found among the three groups of patients in the measurements of the middle cartilage of the lateral femoral condyle, the posterior cartilage of the lateral femoral condyle, the anterior cartilage of the lateral tibial plateau, the middle cartilage of the lateral tibial plateau, and the posterior cartilage of the lateral tibial plateau (P < 0.05). 2. No significant differences were observed in the measurements of the anterior cartilage of the lateral femoral condyle, the cartilage of the medial femoral condyle, and the cartilage of the medial tibial plateau (P > 0.05). 3. Pairwise comparisons between the three groups revealed that: In the comparisons between the normal meniscus control group and both the intact discoid meniscus group and the ruptured discoid meniscus group, significant differences were found in the above five measurement points (P < 0.05). In the comparison between the intact discoid meniscus group and the ruptured discoid meniscus group, no significant differences were found in these five measurement points (P > 0.05). Conclusion: Based on MRI observations, discoid meniscus affects the cartilage thickness of the weight-bearing surface of the lateral femoral condyle and the lateral tibial plateau. This effect originates from the discoid meniscus itself, meaning that the cartilage thickness in the aforementioned areas is influenced by the presence of a discoid meniscus, regardless of whether it is ruptured or not.