3D弥散法MR膝关节造影对半月板损伤诊断价值的探讨  

Diagnostic value of 3D-indirectmagnetic resonance arthrography in detecting meniscal tears of the knees

作　　者：王蓼[1] 叶如卿[1] 江凯[1] 吴元华[1] 吴盛赞 邓生德[1] 汪建华[1] 

机构地区：[1]宁波大学医学院附属医院影像科,浙江宁波315020

出　　处：《中国骨伤》2015年第3期282-285,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨3D弥散法MR膝关节造影诊断半月板撕裂的临床应用价值。方法 :收集自2013年1月至2014年1月的42例临床怀疑半月板撕裂的患者,其中男31例,女11例;年龄21~67岁,平均38.4岁;病程2 h^15 d;临床症状是膝关节痛。首先采用膝关节常规MR平扫,然后进行3D弥散法MR膝关节造影检查,全部病例经关节镜或手术证实,将常规平扫结果和3D弥散法关节造影诊断结果与关节镜或手术结果对照,对比两种方法在显示半月板撕裂图像敏感性和特异性方面的差异。结果:3D弥散法MR膝关节造影使半月板撕裂处信号强度明显高于常规平扫,同时检查的敏感性从52.94%(54/102)提高到85.79%(87/102),特异性从67.78%(61/90)提高到86.67%(78/90)。对两种方法进行χ2检验,敏感性及特异性之间差异有统计学意义(χ2=25.90,P<0.01;χ2=9.13,P<0.01)。结论 :3D弥散法膝关节造影对半月板撕裂图像敏感性及特异性均优于常规MR平扫。Objective：To explore the diagnostic value of 3D-indirectmagnetic resonance （MR） arthrography in detecting meniscustears of the knees. Methods：Form January 2013 to January 2014, routine plain MR of the knees followed by the 3D- indirect MR arthrography was performed in 42 patients with suspected meniscal tears clinically. There were 31 males and 11 females, with an average age of 38.4 years old （ranged, 21 to 67 years old）. The duration of the course ranged from 2 h to 15 d. The clinical symptom was knee pain. All the patients got subsequently arthroscopic examination or operation. The sensitivity and specificity of routine plain MR and 3D-indirect MR arthrography were compared based on the results of arthroscopic ex- amination or operation. Results ：The signal intensity in the area of meuiscal tears on image of 3D-indirect MR arthrography was obviously higher than that of routine plain MR. The sensitivity of 3D-indirect MR arthrography was 85.79% （87/102）, while the routine plain MR was 52.94% （54/102 ）, and the specificity improved from 67.78% （61/90） to 86.67% （78/90 ）. The difference was statistically significant （X2=25.90, P〈0.01 ; X2=9.13 ,P〈0.01 ）. Conclusion：In comparison with the routine plain MR findings, 3D-indirect MR arthrography demonstrates meniscus tears of the knee with the better sensitivity and specificity.

关 键 词：膝关节 磁共振成像 半月板 胫骨 

分 类 号：R445.2[医药卫生—影像医学与核医学]