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A Torção Tibial (TT) é uma das principais deformações dos membros inferiores, sobretudo em crianças, a qual produz uma mudança no alinhamento dos planos de movimento das articulações proximal e distal da tíbia. Esta patologia tem sido diagnosticada e avaliada através do exame de Tomografia Computorizada que utiliza Radiação Ionizante (RI), podendo causar danos graves nas células, tecidos e órgãos. Propõe-se a avaliação desta patologia músculo-esquelética através da Ressonância Magnética (RM) por ser um método sem recurso à RI, e que possui boa resolução espacial e tecidular. No presente estudo pretende-se adaptar um método de quantificação e avaliação da TT através da RM. Para tal foram realizados exames de RM a 104 indivíduos, com idade média de 20,7 ± 2,3 anos, usando um GE OPTIMA 1,5 Tesla. Posteriormente 10 destes realizaram novo exame para obtenção de modelos 3D num equipamento MAGNETOM Sempra 1,5 Tesla. O ângulo da TT foi medido entre a porção distal e proximal através dos métodos propostos por Jakob (1980) e Goutallier (2006). Pela análise estatística conclui-se que os dados obtidos se ajustam à distribuição normal, e que existem diferenças estatisticamente significativas entre os métodos. Observa-se que os valores do Método Jakob em média são superiores ao Método Goutallier e em ambos os intervalos estão próximos do intervalo descrito na literatura. Nas variáveis ‘género’, ‘índice de massa corporal’, ‘sofrer de lesão músculo-esquelética’ e ‘prática de exercício físico’, não foram detetadas diferenças estatisticamente significativas entre as categorias em qualquer um dos métodos, p > α (α = 5%). A metodologia desenvolvida permitiu concluir que a RM é um método reprodutível para analisar a TT, no entanto, este modelo de avaliação poderá ser complementado com o desenvolvimento de métodos de análise computorizada da anatomia óssea em 3D.
Abstract Tibial Torsion (TT) is one of the main deformities of the lower limbs, especially in children, which produces a change in the alignment of the planes of movement of the proximal and distal tibial joints. This pathology has been diagnosed and evaluated through the Computed Tomography exam that uses Ionizing Radiation (IR), and can cause severe damage to cells, tissues, and organs. It is proposed to evaluate this musculoskeletal pathology through Magnetic Resonance Imaging (MRI) because it is a method that does not use IR and has good spatial and tissue resolution. The present study aims to adapt a method to quantify and evaluate TT using MRI. To this end, MRI scans were performed on 104 individuals, with a mean age of 20.7 ± 2.3 years, using a GE OPTIMA 1.5 Tesla. Afterwards, 10 of these individuals underwent a new examination to obtain 3D models in a MAGNETOM Sempra 1.5 Tesla. The TT angle was measured between the distal and proximal portions using the methods proposed by Jakob (1980) and Goutallier (2006). By statistical analysis it is concluded that the data obtained fit the normal distribution, and that there are statistically significant differences between the methods. The Jakob Method values on average are higher than the Goutallier Method and in both ranges are close to the range described in the literature. In the variable’s 'gender', 'body mass index', 'suffering from musculoskeletal injury' and 'physical exercise practice', no statistically significant differences were detected between the categories in any of the methods, p > α (α = 5%). The methodology developed allowed us to conclude that MRI is a reproducible method to analyse TT; however, this evaluation model needs to be complemented with the development of computerized 3D bone anatomy analysis methods.
Abstract Tibial Torsion (TT) is one of the main deformities of the lower limbs, especially in children, which produces a change in the alignment of the planes of movement of the proximal and distal tibial joints. This pathology has been diagnosed and evaluated through the Computed Tomography exam that uses Ionizing Radiation (IR), and can cause severe damage to cells, tissues, and organs. It is proposed to evaluate this musculoskeletal pathology through Magnetic Resonance Imaging (MRI) because it is a method that does not use IR and has good spatial and tissue resolution. The present study aims to adapt a method to quantify and evaluate TT using MRI. To this end, MRI scans were performed on 104 individuals, with a mean age of 20.7 ± 2.3 years, using a GE OPTIMA 1.5 Tesla. Afterwards, 10 of these individuals underwent a new examination to obtain 3D models in a MAGNETOM Sempra 1.5 Tesla. The TT angle was measured between the distal and proximal portions using the methods proposed by Jakob (1980) and Goutallier (2006). By statistical analysis it is concluded that the data obtained fit the normal distribution, and that there are statistically significant differences between the methods. The Jakob Method values on average are higher than the Goutallier Method and in both ranges are close to the range described in the literature. In the variable’s 'gender', 'body mass index', 'suffering from musculoskeletal injury' and 'physical exercise practice', no statistically significant differences were detected between the categories in any of the methods, p > α (α = 5%). The methodology developed allowed us to conclude that MRI is a reproducible method to analyse TT; however, this evaluation model needs to be complemented with the development of computerized 3D bone anatomy analysis methods.
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Palavras-chave
Torção tibial Radiação Ionizante Ressonância magnética Método Jakob Método Goutallier Tibial torsion Ionizing radiation Magnetic resonance Jakob method Goutallier method