MR与关节镜诊断半月板损伤的临床价值研究  

Comparative study of magnetic resonance imaging and knee arthroscopy in the diagnosis of meniscus injury

作　　者：庞博 龚金山[1] 

机构地区：[1]内蒙古民族大学,内蒙古通辽028000

出　　处：《医学影像学杂志》2017年第9期1782-1784,1792,共4页Journal of Medical Imaging

摘　　要：目的探讨MR与关节镜诊断半月板损伤的临床价值。方法本组72例患者检查86个膝关节,共172例半月板,入院后进行MRI检查评价半月板损伤情况,2周内进行膝关节镜检查,MRI检查结果按Fischer分级标准分I级信号、II级信号、III级信号,关节镜检查结果分正常、退变、撕裂。结果 MRI与关节镜检查诊断半月板损伤结果比较,X^2=1.432,P=0.698,κ=0.694;MRI与关节镜检查诊断半月板撕裂结果比较,X^2=0.529,P=0.629,κ=0.767,MRI诊断半月板撕裂的敏感度86.27%、特异度91.73%、阳性预测值81.48%、阴性预测值94.07%、阳性似然比10.43、阴性似然比0.15、准确度90.12%、假阳性率8.27%、假阴性率13.73%。结论 MRI能够较好的诊断半月板损伤的程度,特别是对半月板撕裂的诊断,MRI的Ⅲ级信号可作为临床选择关节镜检查和手术治疗的一个重要指征。Objective To analyze and evaluate the value of magnetic resonance imaging （ MRI） in the diagnosis of meniscus injury, and to provide a reference basis for the diagnosis and treatment of meniscus injury. Methods 72 patients with 86 knee joints and a total of 172 meniscuses were examined. They underwent MRI examination and the meniscus injury situations were e-valuated after admission, and they underwent knee arthroscopic examination within 2 weeks. According to Fischer grading stand-ard, the MRI findings were graded into gradeⅠsignal, gradeⅡsignal and gradeⅢsignal. The knee arthroscopy findings were graded into normal, degeneration and tear. Results The examination results of MRI were compared with the arthroscopy in the diagnosis of meniscus injury,χ2 =1. 432, P =0. 698,κ =0. 694. The examination results of MRI were compared with the arthro-scopy in the diagnosis of meniscal tear,χ2 =0. 529, P =0. 629,κ =0. 767. In the diagnosis of meniscus tear, the sensitivity of MRI was 86. 27%, specificity was 91. 73%, positive predictive value was 81. 48%, negative predictive value was 94. 07%, pos-itive likelihood ratio was10. 43, negative likelihood ratio was 0. 15, accuracy was 90. 12%, false positive rate was 8. 27%, and false negative rate was 13. 73%. Conclusion MRI can better diagnose the degree of meniscus injury, especially for meniscal tear, which has an important clinical value. GradeⅢsignal of MRI can be used as an indication for clinical choice of arthroscopy and surgery treatment.

关 键 词：磁共振成像 半月板损伤 关节镜 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681[医药卫生—诊断学]