MRI技术诊断膝关节前交叉韧带断裂的序列应用探讨  

Application of MRI in Diagnosis of Rupture of Anterior Cruciate Ligament of Knee Joint

作　　者：郭剑华 易海玲[1] GUO Jianhua;YI Hailing(Huidong Hospital Affiliated to Guangdong Medical College,Huidong 516300,China)

机构地区：[1]广东医学院附属惠东医院,广东惠东516300

出　　处：《中国医学创新》2018年第20期66-70,共5页Medical Innovation of China

摘　　要：目的:研究并探讨磁共振成像(magnetic resonance imaging,MRI)技术在膝关节前交叉韧带断裂诊断中的临床应用价值。方法:选择2015年1月-2017年10月在本院就诊的75例疑似膝关节前交叉韧带断裂患者为研究对象,所有患者均接受超声、MRI检查,分析其超声、MRI诊断结果。以关节镜诊断结果作为金标准,计算超声、MRI对膝关节前交叉韧带断裂的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值,再采用Kappa一致性检验,分析超声、MRI诊断结果与关节镜诊断结果之间的一致性。结果:75例疑似患者中,经关节镜确诊58例膝关节前交叉韧带断裂。以关节镜诊断结果为金标准,MRI对膝关节前交叉韧带断裂的诊断灵敏度为96.55%,特异度为94.12%,准确率为96.00%,阳性预测值为98.25%,阴性预测值为88.89%;超声对膝关节前交叉韧带断裂的诊断灵敏度为81.03%,特异度为64.71%,准确率为77.33%,阳性预测值为88.68%,阴性预测值为50.00%;MRI对膝关节前交叉韧带断裂的灵敏度、特异度、准确率、阳性预测值、阴性预测值均高于超声(P<0.05)。经一致性检验,MRI诊断结果与关节镜诊断结果之间的一致性良好(Kappa=0.729),而超声诊断结果与关节镜诊断结果之间的一致性仅为中等(Kappa=0.541)。结论:在膝关节前交叉韧带断裂诊断中,采用MRI诊断可对前交叉韧带断裂予以灵敏、准确检出,其诊断价值显著;在扫描序列应用中,斜矢状位STIR序列显示前交叉韧带良好,可以提高诊断前交叉韧带断裂的准确性。Objective：To study and discuss the clinical application value of magnetic resonance imaging（MRI） technology in the diagnosis of anterior cruciate ligament rupture of knee joint.Method：75 patients suspected of anterior cruciate ligament rupture in our hospital from January 2015 to October 2017 were selected.All patients were examined by ultrasound and MRI,and the results of ultrasound and MRI were analyzed.Using arthroscopic diagnosis results as the gold standard,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ultrasound and MRI for the rupture of anterior cruciate ligament of knee joint were calculated.Kappa consistency test was used to analyze the consistency between ultrasonic and MRI diagnostic results and arthroscopic findings.Result：In 75 suspected patients,58 cases of anterior cruciate ligament（ACL） fracture of the knee were diagnosed by arthroscopy.Arthroscopic findings were the gold standard,the diagnostic sensitivity of MRI for the rupture of anterior cruciate ligament of knee joint was 96.55%,the specificity was 94.12%,the accuracy was 96.00%,the positive predictive value was 98.25%,and the negative predictive value was 88.89%;the sensitivity of ultrasound in the diagnosis of anterior cruciate ligament of knee joint fracture was 81.03%,the specificity was 64.71%,the accuracy rate was 77.33%,the positive predictive value was 88.68%,the negative predictive value was 50.00%.The sensitivity, specificity,accuracy,positive predictive value and negative predictive value of MRI to anterior cruciate ligament of knee joint fracture were higher than that of ultrasound（P〈0.05）.The consistency between MRI diagnosis and arthroscopic diagnosis was good（Kappa=0.729）,the consistency between ultrasound diagnosis and arthroscopic diagnosis was only moderate（Kappa=0.541）.Conclusion：In the diagnosis of knee joint anterior cruciate ligament rupture,the MRI diagnosis of anterior cruciate ligament rupture to be sensitive and accurate detec

关 键 词：磁共振成像 斜矢状位STIR序列 膝关节 前交叉韧带断裂 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.5[医药卫生—诊断学]