中文摘要：

目的 探讨膝关节骨性关节炎（osteoarthritis, OA）患者并发前交叉韧带（anterior cruciate ligament, ACL）损伤与髁间窝狭窄之间的关系。 方法 把K-L评分Ⅱ级以上的75例中重度OA患者依据是否并发ACL损伤分为两组，单纯OA组40例，OA合并ACL损伤组35例，观察MRI图像轴位序列上髁间窝形状，分为A、U、W三型，并分别测量轴位、冠状位、ACL股骨止点位3个平面的髁间窝宽度指数（notch width index, NWI）。分析两组患者的髁间窝分型、各平面NWI之间的差异，并依据ROC曲线算出不同平面NWI界值，确定髁间窝狭窄的指标，明确髁间窝狭窄与OA患者并发ACL损伤之间的关系。 结果 单纯OA组、OA合并ACL损伤组在轴位、冠状位、ACL股骨止点位NWI分别为NWI-1：0.270±0.010、0.257±0.011，NWI-2：0.252±0.012、0.237±0.017，NWI-A：0.262±0.016、0.240±0.018，差异有统计学意义 （P〈0.01），后者A型所占比例比前者多（P〈0.05）。依据ROC曲线得出不同平面髁间窝狭窄的NWI界值分别为NWI-1＜0.263、NWI-2＜0.248、NWI-A＜0.254。3个平面中NWI-1的特异度最高，NWI-A的灵敏度最高。 结论 髁间窝狭窄及髁间窝A型可能是中重度OA患者并发ACL损伤的危险因素。

英文摘要：

Objective To investigate the correlation of anterior cruciate ligament （ACL） injury and intercondylar notch stenosis in osteoarthritis （OA） patients. Methods A total of 75 moderatesevere OA patients （≥45 years old） with K-L score of grade Ⅱ or above were selected from 1 107 in- and out-patients undergoing knee MR imaging in our hospital from 2011 to 2014. They were divided into 2 groups based on whether complicated with ACL injury, that is, simple OA group （n=40） and OA complicated with ACL injury group （n=35）. According to the axial sequence in MR images, there were A, U and W shapes in the types of intercondylar notch. The notch width index （NWI） in the sequences of axial, coronal, and ACL attachment point at the femoral were measured respectively. The differences of intercondylar notch shape and 3 sequences of NWI were analyzed between the 2 groups. The cutoff values of NWI in different sequences were calculated according to receiver operating characteristic （ROC） curve to determine intercondylar notch narrowing. Then the correlation of ACL injury and intercondylar notch stenosis was analyzed. ResultsThe NWI in the sequences of axial, coronal, ACL attachment point at the femoral were NWI1=0.270±0.010, NWI2=0.252±0.012 and NWIA=0.262±0.016 in the simple OA group, and were NWI1=0.257±0011, NWI2=0.237±0.017 and NWIA=0.240±0.018 respectively in the OA complicated with ACL injury group, and significant differences were found between the 2 groups （P〈0.01）. The proportion of type A was significantly larger in the latter than the former group （P〈0.05）. ROC curve indicated that NWI1〈0.263, NWI2〈0.248 and NWIA〈0.254 were the cutoff values for the intercondylar notch narrowing of the 3 sequences. Among them, NWI1 was of the highest specificity, and NWIA was of the highest sensitivity. ConclusionIntercondylar notch stenosis and type A shape may be the risk factors for moderatesevere OA patients complicated with ACL injury.