南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (10): 1384-.

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冠状位髁间窝宽度指数与骨关节炎的关系

陈聪，马愔花，谭小义，张波，耿彬，姜金，吴萌，夏亚一   

  • 出版日期:2015-10-20 发布日期:2015-10-20

Relationship between coronal intercondylar notch width index and osteoarthritis

  • Online:2015-10-20 Published:2015-10-20

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摘要： 目的以冠状位髁间窝宽度指数（NWI）为依据，探讨膝关节骨性关节炎（OA）与髁间窝狭窄之间的关系。方法收集膝
OA诊断明确的中老年患者的MRI图像，依据K-L评分，把OA患者分为轻度OA组42例，中重度OA组37例，分别与健康组70
例进行对比。计算MRI冠状位不同层面上的髁间窝宽度指数（NWI）、NWI-A、NWI-P，并根据轴位图像把髁间窝形状分为A、
U、W三型。确定OA与NWI、NWI-A、NWI-P、髁间窝分型之间的关系，绘制不同平面NWI的ROC曲线得出最佳界值，依据界
值确定髁间窝狭窄的指标。结果健康、轻度OA、中重度OA组MRI图像冠状位NWI分别为0.252±0.019、0.251±0.017、0.240±
0.020，NWI-A分别为0.261±0.024、0.259±0.023、0.245±0.023，NWI-P分别为0.271±0.026、0.270±0.024、0.254±0.022。中重度
OA组NWI、NWI-A、NWI-P明显比其他两组小（P<0.05），且各层面NWI与是否患中重度OA均有显著的相关性（P<0.01）。冠
状位NWI<0.248、NWI-A<0.256、NWI-P<0.266可以作为髁间窝狭窄的指标。在髁间窝狭窄的患者中A型居多（P<0.05）。结
论中重度OA患者存在明显的髁间窝狭窄，A型比U型容易狭窄。

Abstract: Objective To study the relationship between knee osteoarthritis (OA) and intercondylar notch narrowing based on
the notch width index. Methods Magnetic resonance (MR) images were collected from middle-aged and elderly patients with
a definite diagnosis of knee OA, including 42 with mild OA and 37 with moderate to severe OA, with 70 healthy individuals
serving as the control group. The notch width indexes NWI, NWI-A, and NWI-P on the coronal images at different levels were
calculated, and the intercondylar notch was classified, according to the features on axial MR images, into types A, U, and W.
The association of OA with NWI, NWI-A, NWI-P, and notch type was determined, and the cutoff values were obtained based
on the ROC curves at different levels as indicators for diagnosis of intercondylar notch stenosis. Results In the control, mild
OA, moderate to severe OA groups, the NWI value on coronal MR images were 0.252±0.019, 0.251±0.017, and 0.240±0.020,
NWI-A were 0.261±0.024, 0.259±0.023, and 0.245±0.023, and NWI-P were 0.271±0.026, 0.270±0.024, and 0.254±0.022, respectively.
Patients with moderate to severe OA had significantly smaller NWI, NWI-A, and NWI-P than the other two groups (P<0.05),
and a significant association was found between NWI values at each level and the occurrence of moderate to severe OA (P<
0.01). A NWI value<0.248, NWI-A<0.256, and NWI-P<0.266 supported a diagnosis of intercondylar notch narrowing. Type A
intercondylar notch was found in the majority of patients with intercondylar notch narrowing (P<0.05). Conclusion Patients
with moderate to severe OA have significant intercondylar notch narrowing, and patients with a type A intercondylar notch
are more likely to have intercondylar notch narrowing than those with type U notch.