MRI、X线与CT在膝关节损伤临床诊断中的应用  

Application of MRI, X-ray, and CT in clinical diagnosis of knee joint injury

作　　者：朱思光 孙涛[2] ZHU Si-guang;SUN Tao(Department of Radiology,Renhe Hospital of Baoshan District of Shanghai,Shanghai 200431,CHINA;Department of Radiology,Jiangsu Provincial People's Hospital,Nanjing 210029,Jiangsu,CHINA)

机构地区：[1]上海市宝山区仁和医院放射科,上海200431 [2]江苏省人民医院放射科,江苏南京210029

出　　处：《海南医学》2019年第24期3244-3246,共3页Hainan Medical Journal

摘　　要：目的比较MRI检查、X线检查与CT检查对膝关节损伤患者的临床诊断效果。方法回顾性选择2014年3月至2019年3月上海市宝山区仁和医院收治且符合纳入标准的疑似膝关节损伤患者303例,全部患者均行X线检查、CT检查与MRI检查,以手术探查结果为金标准,对比不同检查方式的诊断准确性。结果(1)303例疑似膝关节损伤患者确诊228例,占75.25%,阴性75例,占24.75%。其中X线检查阳性215例,占70.96%;阴性88例,占29.04%;CT检查阳性221例,占72.94%,阴性82例,占27.06%;MRI检查阳性227例,占74.92%,阴性76例,占25.08%;(2)疑似膝关节损伤MRI检查诊断灵敏度、特异度、准确性分别为98.25%、96.00%、97.69%,均明显高于X线检查的89.47%、85.33%、88.45%,差异均有统计学意义(P<0.05);MRI检查诊断的阴性预测值和阳性预测值分别为94.74%、98.68%,均明显高于X线检查的72.73%、94.88%,差异均有统计学意义(P<0.05);MRI检查与CT检查的特异度(88.00%vs 96.00%)和阳性预测值(95.93%vs 98.68%)比较差异均无统计学意义(P>0.05),而MRI检查灵敏度、准确性、阴性预测值分别为98.25%、97.69%、94.74%,均明显高于CT检查的92.98%、91.75%、80.49%,差异均有统计学意义(P<0.05)。结论X线、CT与MRI检查均能够对患者膝关节损伤情况作出诊断,但MRI检查诊断准确性较高。Objective To compare the effect and value of MRI,X-ray,and CT in the clinical diagnosis of patients with knee joint injury.Methods From March 2014 to March 2019,303 patients with suspected knee injury admitted in Renhe Hospital of Baoshan District of Shanghai and meeting the inclusion criteria were selected.All patients underwent X-ray examination,CT examination,and MRI examination.Results(1)Among the 303 patients,228(75.25%)were diagnosed as knee injury,and 75(24.75%)were negative.X-ray examination showed 215 cases were positive(accounting for 70.96%)and 88 cases were negative(accounting for 29.04%);CT examination showed 221 cases were positive(72.94%)and 82 cases were negative(27.06%);MRI examination showed 227 cases were positive(accounting for 74.92%)and 76 cases were negative(25.08%).(2)The sensitivity(98.25%),specificity(96.00%),and accuracy(97.69%)of MRI diagnosis of suspected knee joint injury were significantly higher than those of X-ray examination(89.47%,85.33%,and 88.45%),and the differences were statistically significant(P<0.05).The negative and positive predictive value of MRI were 94.74%,98.68%,both significantly higher than 72.73%,94.88%of X-ray examination(P<0.05).MRI and CT examination showed no significant difference in specificity(88.00%vs 96.00%,P>0.05)and positive predictive value(95.93%vs 98.68%,P>0.05),while MRI had significantly higher sensitivity(98.25%vs 92.98%,P<0.05),accuracy(97.69%vs 91.75%,P<0.05)and negative predictive value(94.74%vs 80.49%,P<0.05).Conclusion X-ray,CT,and MRI examination can be used to diagnosis the knee joint injury of patients,but MRI examination has a high diagnostic accuracy,which should be promoted in clinical practice.

关 键 词：膝关节损伤 伦琴射线检查 计算机体层摄影 核磁共振成像 准确性 

分 类 号：R684[医药卫生—骨科学]