薄层斜矢状位MRI对前交叉韧带损伤的诊断价值  

Diagnostic value of thin-slice oblique sagittal MRI in anterior cruciate ligament injuries

作　　者：杨严伟 杜君 黄军[1] 王庆恭 黄立新[2] 杨惠林[2] YANG Yanwei;DU Jun;HUANG Jun;WANG Qinggong;HUANG Lixin;YANG Huilin(Orthopedics Magnetic Resonance Room,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215000,China;Department of Orthopedics,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215000,China)

机构地区：[1]苏州大学附属第一医院骨科磁共振室,江苏苏州215000 [2]苏州大学附属第一医院骨科,江苏苏州215000

出　　处：《实用放射学杂志》2021年第12期2031-2034,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81701649)。

摘　　要：目的探讨薄层斜矢状位MRI对前交叉韧带(ACL)损伤的诊断价值。方法对62例患者的膝关节MRI(包括薄层斜矢状位序列)图像进行分析,以关节镜为金标准,分别比较常规MRI、薄层斜矢状位MRI诊断ACL损伤与关节镜的一致性,并比较常规MRI与薄层斜矢状位MRI诊断ACL损伤的差异。结果薄层斜矢状位MRI诊断ACL损伤与关节镜的一致性好(Kappa=0.704,P<0.001)且优于常规MRI(Kappa=0.284,P=0.002);薄层斜矢状位MRI诊断ACL断裂(部分断裂+完全断裂)、部分断裂、完全断裂的真实性评价(灵敏度、特异度、误诊率、漏诊率、阳性预测值、阴性预测值、准确率)结果及与关节镜的一致性均优于常规MRI,进一步比较中,两者诊断ACL部分断裂的差异有统计学意义(χ^(2)=4.348,P=0.035)。结论薄层斜矢状位MRI较常规MRI能够更好地显示ACL损伤,特别是部分断裂。Objective To investigate the diagnostic value of thin-slice oblique sagittal MRI in anterior cruciate ligament(ACL)injuries.Methods MR images(including thin-slice oblique sagittal sequence)of 62 patients were analyzed,and their arthroscopy results were used as the gold standard to compare the diagnostic accuracy and consistency between conventional MRI and thin-slice oblique sagittal MRI in diagnosis of ACL injuries.Results The diagnostic consistency of thin-slice oblique sagittal MRI and arthroscopy(Kappa=0.704,P<0.001)was higher than conventional MRI(Kappa=0.28A,P=0.002)in diagnosing ACL injuries.The sensitivity,specificity,mistake diagnostic rate,omission diagnostic rate,positive predictive value,negative predictive value,and accuracy rate of thin-slice oblique sagittal MRI were better than conventional MRI respectively.The consistency of thin-slice oblique sagittal MRI in diagnosis of ACL rupture(partialH-complete rupture),partial rupture,and complete rupture were all better with a significant statistical difference in diagnosis of ACL partial rupture(χ^(2)=4.348,P=0.035).Conclusion The thin-slice oblique sagittal MRI is better than conventional MRI for diagnosis of ACL injuries,especially for ACL partial rupture.

关 键 词：前交叉韧带 薄层斜矢状位 磁共振成像 

分 类 号：R686.5[医药卫生—骨科学] R445.2[医药卫生—外科学]