联合应用CT与MRI对前交叉韧带损伤分级的诊断价值  

Diagnostic value of combined application of CT and MRI in the classification of anterior cruciate ligament injury

作　　者：任瑞[1] 宋琼[2] 杨敬媛 周金亮 REN Rui;SONG Qiong;YANG Jingyuan;ZHOU Jinliang(Outpatient Department,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Cardiology Department,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Radiology Department,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院门诊部,山东滨州256603 [2]滨州医学院附属医院心血管内科,山东滨州256603 [3]滨州医学院附属医院放射科,山东滨州256603

出　　处：《滨州医学院学报》2022年第3期224-227,共4页Journal of Binzhou Medical University

基　　金：山东省医药卫生科技计划(2016WS0035)。

摘　　要：目的探讨联合应用CT与MRI对前交叉韧带(ACL)损伤分级的临床诊断价值。方法回顾性分析120例膝关节损伤患者临床资料,根据关节镜检查结果将ACL损伤情况分为正常、损伤和断裂三级,比较CT、MRI及CT+MRI检查对ACL损伤分级的诊断准确率、敏感性、特异性。结果120例患者中,经关节镜证实,ACL正常者64例,损伤者28例,断裂者28例。CT、MRI及CT+MRI诊断ACL损伤情况总诊断准确率分别为67.5%(81/120)、89.2%(107/120)、94.2%(113/120),三组比较差异有统计学意义(χ^(2)=35.19,P<0.001),其中CT与MRI、CT+MRI总诊断准确率比较差异均有统计学意义(χ^(2)=16.60,P<0.001;χ^(2)=13.54,P<0.001),MRI与CT+MRI比较差异无统计学意义(χ^(2)=1.96,P=0.242)。CT、MRI及CT+MRI对ACL正常的诊断准确率分别为79.7%(51/64)、93.8%(60/64)、95.3%(61/64),差异有统计学意义(χ^(2)=10.16,P=0.008),其中CT与MRI、CT+MRI比较差异均有统计学意义(χ^(2)=5.49,P=0.035;χ^(2)=7.14,P=0.014),MRI与CT+MRI比较差异无统计学意义(Fisher精确检验,P=1.0)。CT、MRI及CT+MRI对ACL损伤的诊断准确率分别为46.4%(13/28)、82.1%(23/28)、92.9%(26/28),差异有统计学意义(Fisher精确检验,P<0.001)。其中CT与MRI、CT+MRI比较差异均有统计学意义(Fisher精确检验,P=0.011;P<0.001),MRI与CT+MRI比较差异无统计学意义(Fisher精确检验,P=0.422)。CT、MRI及CT+MRI对ACL断裂的诊断准确率分别为60.7%(17/28)、85.7%(24/28)、92.9%(26/28),差异有统计学意义(Fisher精确检验,P=0.011),其中CT与MRI比较差异无统计学意义(Fisher精确检验,P=0.068),CT与CT+MRI比较差异有统计学意义(Fisher精确检验,P=0.010),MRI与CT+MRI比较差异无统计学意义(Fisher精确检验,P=0.669)。MRI、CT+MRI诊断ACL损伤的敏感性分别为96.4%、98.2%,均高于CT(66.1%);特异性分别为93.8%、95.3%,亦高于CT(79.7%)。结论MRI诊断ACL各级损伤的准确率均较高,CT+MRI联合诊断ACL断裂的准确率高于CT。CT诊断ACL正常、断裂具有相�Objective To explore the clinical diagnostic value of combined application of CT and MRI in the classification of anterior cruciate ligament(ACL)injury.Methods The clinical data of 120 patients with knee injuries were retrospectively analyzed.According to the results of arthroscopy,the ACL injuries were divided into three grades:normal,injury and fracture.The diagnostic accuracy,sensitivity and specificity of CT,MRI and combined CT and MRI examinations in the classification of ACL injuries were compared.Results Among the 120 patients,64 were confirmed by arthroscopy that the ACL was normal,28 were injured,and 28 were broken.The total diagnostic accuracy of CT,MRI,combined CT and MRI in the diagnosis of ACL injury was 67.5%(81/120),89.2%(107/120),and 94.2%(113/120),respectively,and the comparison of the three groups was statistically significant(χ^(2)=35.19,P<0.001).There were statistically significant differences in total diagnostic accuracy between CT and MRI,and between CT and MRI(χ^(2)=16.60,P<0.001;χ^(2)=13.54,P<0.001),while there was no statistically significant difference between MRI and CT+MRI(χ^(2)=1.96,P=0.242).The diagnostic accuracy of CT,MRI and CT+MRI in normal ACL was 79.7%(51/64),93.8%(60/64),and 95.3%(61/64),respectively,and the difference was statistically significant(χ^(2)=10.16,P=0.008).There were statistically significant differences in diagnostic accuracy between CT and MRI,and between CT and MRI(χ^(2)=5.49,P=0.035;2=7.14,P=0.014),and there was no statistical difference between MRI and CT+MRI(Fisher′s exact test,P=1.0).The diagnostic accuracy of CT,MRI and CT+MRI in ACL injury was 46.4%(13/28),82.1%(23/28)and 92.9%(26/28),respectively,and the difference was statistically significant(Fisher′s exact test,P<0.001).There were statistical differences between CT and MRI,and between CT and CT+MRI(Fisher′s exact test,P=0.011;P<0.001),and there was no statistical difference between MRI and CT+MRI(Fisher′s exact test,P=0.422).The diagnostic accuracy of CT,MRI and CT+MRI for ACL fracture w

关 键 词：前交叉韧带 计算机体层成像 磁共振成像 诊断价值 

分 类 号：R686.5[医药卫生—骨科学] R445[医药卫生—外科学]