Hoffa病与髌骨运动轨迹异常相关性的MRI研究

目的：探讨Hoffa病与髌骨运动轨迹异常的相关性。方法：回顾性分析46例经MRI证实为髌下脂肪垫水肿的Hoffa病患者（病例组）及28例健康体检者（对照组）的MRI及临床资料。病例组中11例行关节镜治疗及病理学检查。在MRI图像上测量5个髌骨运动轨迹参数，包括股骨滑车深度、股骨滑车与胫骨结节的水平距离（TTTG）、髌骨外移度、外侧髌股角（PFA）和InsallSalvati指数。对这5个指标在病例组和正常组问的差异进行统计学分析。结果：Hoffa病的髌下脂肪垫水肿在脂肪抑制T2WI及PDWI序列上显示清晰，均呈高信号改变。病例组及对照组股骨滑车与胫骨结节的距离（TTTG）、外侧髌股角（PFA）和Insall-Salvati指数间的差异有统计学意义（Z值分别为-2．523、-2．261和-2．812，P值均〈0．05），两组间滑车深度及髌骨外移度的差异无统计学意义（z值分别为-1．025和-0．111，P值均〉0．05）。病例组内出现髌骨外移度（〉3mm）、外侧髌股角（PFA≤0°）和Insall-Salvati指数（〉1．2）异常者较对照组多，两组间差异有统计学意义（X^2值分别为6．917、5．572和9．582，P值均〈0．05）。结论：Hoffa病的主要MRI表现为髌下脂肪垫水肿，MRI是本病的首选检查方法；Hoffa病与髌骨运动轨迹异常间有相关性。

MRI study on correlation between Hoffa disease and patellar maltracking

Objective：To investigate the correlation between Hoffa disease and patellar maltracking by MRI. Methods： The clinical and MRI data of 46 cases with Hoffa disease （patient group） and 28 healthy volunteers （contrast group） were retrospectively analyzed. In patient group, 11 cases were performed arthroscopic treatment and pathological examination. On MRI images, the five patellar maltracking parameters were measured,including trochlear depth, tibial tuberosity trochlear groove distance （TTTG）,patellar translation, patellofemoral angle （PFA） and the Insall--Salvati index. The difference of these five parameters in patient group and contrast group were analyzed statistically. Results：The infrapatellar fat pad of Hoffa disease was showed clearly with hyperintensity on fat suppression Tz WI and PDWh There was a statistical difference in the TTTG,PFA and Insall-Salvati index between the two groups （Z=-2. 523,-2. 261 and -2. 812 respectively, P〈 0.05） ,and the difference of trochlear depth and patellar translation of two groups was not statistically significant （Z = -1. 025 and -0. 111 respectively,P〉0.05）. There was a higher prevalence of abnormal patellar translation（〉3mm）, patellofemoral angle （PFA≤0°） and Insall Salvati index （〉1.2） in the patient group （X^2 =6. 917,5. 572 and 9. 582 respectively,P〈0.05）. Conclusion： MRI is the first choice for diagnosis of Hoffa disease with the imaging features of infrapatellar fat pad oedema. Hoffa disease is correlated with patellar maltracking.