MRI诊断女子排球运动员髌腱腱病

目的 探讨女子排球运动员髌腱腱病(PT)的MRI表现。方法 回顾性分析34名中国国家女子排球队运动员60个膝关节的MRI资料。结果 60个膝关节中,41个(26例)有PT(PT组),患病率76.47%,其中信号增强2级以上占82.93%(34/41)。13名19个膝关节阴性为对照组。PT组髌腱近端、中点、下止点前后径分别为(9.21±2.31)mm、(5.39±1.01)mm、(6.53±1.32)mm,与对照组相比差异有统计学意义(P<0.01)。PT组髌腱近端前后径与分级相关(r=0.334,P<0.01)。PT急性期髌腱近端增粗,T1WI低信号,T2WI中、高信号,FS-PDWI高信号;慢性期髌腱近端呈"V"形增粗增厚,T1WI低信号,T2WI中、低信号,FS-PDWI中等信号。髌腱近端后缘紊乱不清晰、髌腱中部和下止点信号增强以及髌骨下极增生等在两组间差异均有统计学意义(P<0.05)。所有患膝可见髌骨下极不规则片状、大小不一的信号增强。结论 女子排球运动员PT患病率较高。MRI有助于明确诊断、分期分级,鉴别髌骨下极损伤,监控康复效果以及评估运动能力。

MRI diagnosis of patellar tendinopathy in female volleyball players

Objective To observe MRI appearances of patellar tendinopathy (PT) in female volleyball players. Methods MRI data of 60 knees of 34 members of Chinese country female volleyball team were analyzed retrospectively. Results PT was diagnosed in 26 patients (41 knees, PT group). The morbidity rate was 76.47%, and 82.93% of the knees were classified above grade 2. Thirteen members (19 knees negative) were as control group. The average diameter of proximal patellar tendon, midpoint, distal in PT group was (9.21±2.31)mm, (5.39±1.01)mm and (6.53±1.32)mm, respectively. There was significant difference in the diameter and signal of patellar tendon between PT group and the control group (P<0.01). There was positive correlation between the diameter of patellar tendon and the grade of PT (r=0.334, P<0.01). PT manifested as the enlargement of proximal patellar tendon, low signal on T1WI, moderate and high signal on T2WI, high signal on FS-PDWI in acute stage, while as the V-shaped enlargement of proximal patellar tendon, low signal on T1WI, moderate and low signal on T2WI, moderate signal on FS-PDWI in chronic stage. Disorder of posterior margin of the proximal patellar tendon, the signal enhancement of middle and the inferior edge of the patellar tendon and hyperplasia of patella pole between the two groups were statistically significant different (P<0.05). All the inferior pole of the patella in PT group showed different sizes of irregular signal enhancement. Conclusion Female volleyball player has high morbidity rate of PT. MRI is useful for the diagnosis, classification of PT and monitoring rehabilitation of the wounded athletes.