MRI与关节镜诊断半月板损伤价值的对照研究  

MRI Diagnosis of Meniscal Injuries of the Knee:Compared with Arthroscopy

作　　者：郭吉敏[1] 刘春霖[2] 曹满瑞[1] 邹立秋[3] 赵艳[3] 郭学军[3] 刘鹏程[3] 

机构地区：[1]广东省深圳市南方医科大学附属深圳妇幼保健院放射科,518028 [2]深圳市第二人民医院放射科,518035 [3]深圳市北京大学深圳医院影像中心,518036

出　　处：《临床放射学杂志》2010年第11期1512-1515,共4页Journal of Clinical Radiology

摘　　要：目的 分析MRI诊断半月板损伤的价值,为临床诊断和治疗半月板损伤提供依据。资料与方法符合纳入标准的168例患者(均为单膝半月板受损),共336个半月板。对膝关节进行术前MRI检查,并于MRI检查后8周内行关节镜术。半月板损伤的MRI分级标准参考Fischer分级法,分为Ⅰ级损伤、Ⅱ级损伤、Ⅲ级损伤;关节镜分级,分为正常、纤毛化和撕裂。结果 与关节镜结果对照,MRI诊断半月板Ⅰ、Ⅱ级损伤的准确性分别为100%、92.9%。诊断半月板撕裂的敏感性、特异性、阳性似然比、准确性、Kappa值分别为93.1%、89.3%、8.7、91.1%、0.82。对半月板撕裂类型诊断总的灵敏性、特异性、阳性似然比、准确性、Kappa值分别为92.0%、79.8%、4.6、84.8%和0.70。结论 MRI不仅能够准确评价半月板损伤程度,而且还能对半月板撕裂进行准确分型。因此,MRI可广泛应用于半月板损伤性疾病的诊断,并进一步指导临床治疗方案的选择。Objective To evaluate the efficacy of MRI in the detection of meniscal injuries of knee.Materials and Methods 168 Patients with persistent symptoms of knee pain underwent MR examination.These patients underwent arthroscopy within eight weeks after MRI examination.According to Stoller grade classification,meniscal injuries was divided into 3 grades-normal,gradeⅠ injury,gradeⅡ injury,and grade Ⅲ injury;while arthroscopic classification,divided into normal,Ⅰgrade injury,meniscal fibrillation,and meniscal tears.Results There are 168 patients（altogether 336 meniscus）were included in our study.Compared with arthroscopy,the accuracy of MRI diagnosing meniscal injury of gradeⅠ,Ⅱ was 100%,92.9% respectively.On MRI images,the sensitivity,specificity,＋LR,accuracy,Kappa value of meniscal injury were 93.1%,89.3%,8.7,91.1%,0.82 respectively.And that of meniscal tears were 92.0%,79.8%,4.6,84.8%,0.70 respectively.The MRI findings were consistent with arthroscopy.Conclusion MRI examination can assess the extent of meniscal injury,but also the patterns of meniscal tears effectively.Therefore,MRI can be used in diagnosis of meniscal injuries,and further guide the clinical planning of meniscal injury therapy.

关 键 词：半月板 磁共振成像 关节镜 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684[医药卫生—诊断学]