MRI对半月板撕裂的诊断效能及影响因素分析  

Diagnostic efficacy and influencing factors of magnetic resonance imaging in meniscus tear diagnose

作　　者：庞成龙 颜世昌[1] 丁惠民[1] 彭俊洋 魏俊成 陈晖[1] PANG Chenglong;YAN Shichang;DING Huimin;PENG Junyang;WEI Juncheng;CHEN Hui(Department of Orthopedics,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院骨科

出　　处：《现代医学》2019年第6期672-676,共5页Modern Medical Journal

基　　金：南京市医学科技发展项目(YKK17250);南京市科委面上项目(201605062);南京市卫生局人才项目(QRX17101)

摘　　要：目的:探讨磁共振成像(MRI)对半月板不同部位撕裂的诊断效能及影响因素。方法:回顾性分析2008年6月至2018年6月本院骨科收治的358例单侧半月板撕裂患者的临床资料,患者均行MRI和关节镜检查,以关节镜检查结果为金标准,分析MRI诊断半月板不同部位撕裂的准确率及其影响因素。结果:MRI诊断半月板撕裂内侧前角准确率94.4%,内侧后角准确率94.7%,内侧体部准确率93.9%,内侧后根准确率93.4%,外侧前角准确率92.5%,外侧后角准确率96.4%,外侧体部准确率94.7%,外侧后根准确率92.7%,Ramp损伤准确率92.2%。MRI对前角撕裂的漏诊率要明显高于后角和体部撕裂(P<0.05)。采用χ^2检验分析影响MRI对半月板撕裂诊断准确性的可能因素,结果显示:MRI对内侧半月板撕裂诊断的误漏诊影响因素为年龄、撕裂部位、撕裂类型和撕裂长度(P<0.05);MRI对外侧半月板撕裂诊断的误漏诊影响因素为撕裂部位、撕裂类型和撕裂长度(P<0.05)。结论:MRI作为目前临床上诊断半月板撕裂最常用的无创方法,具有很高的临床诊断价值,但易受年龄、撕裂部位、撕裂类型和撕裂长度的影响,造成误诊和漏诊。Objective: To investigate the diagnostic efficacy of magnetic resonance imaging( MRI) for the diagnosis of meniscus tear in different sites and its influencing factors. Methods: The clinical data of 358 patients with unilateral meniscus tear admitted to our hospital from June 2008 to June 2018 were analyzed retrospectively.MRI and arthroscopy were performed. The accuracy of MRI for the diagnosis of meniscus tear in different sites and the influencing factors were analyzed by comparing the results with arthroscopy. Results: The results showed that the accuracy rate was 94. 4% for medial anterior horn,94. 7% for medial posterior horn,93. 9% for medial body,93. 4% for medial posterior root,92. 5% for lateral anterior horn,96. 4% for lateral posterior horn,94. 7% for lateral body,92. 7% for lateral posterior root,92. 2% for Ramp lesions. The rate of missed diagnosis of anterior horn tear by MRI was significantly higher than that of posterior horn and body tears( P < 0. 05). The χ^2 test was used to analyze the accuracy of MRI for the diagnosis of meniscus tear and the potential factors. The results showed that the misdiagnosis and missed diagnosis factors of medial meniscus tear by MRI were age,tearing site,tearing type and tearing length( P < 0. 05). The misdiagnosis and missed diagnosis factors of lateral meniscus tear by MRI were tearing site,tearing type and tearing length( P < 0. 05). Conclusion: MRI is the most commonly used noninvasive method in diagnosis of meniscus tear,which shows high diagnostic value. However,it is easily affected to result in misdiagnosis and missed diagnosis by age,tearing site,tearing type and tearing length.

关 键 词：半月板撕裂 磁共振成像 关节镜 诊断效能 

分 类 号：R681.8[医药卫生—骨科学] R684[医药卫生—外科学]