MRI、超声及X线诊断退行性膝关节炎临床价值比较  

Comparison on Clinical Value of MRI,Ultrasound and X-ray in the Diagnosis of Degenerative Osteoarthritis

作　　者：陈钜深 罗建彬[1] CHEN Ju-shen;LUO Jian-bin(Department of Radiology,Panyu District Hospital of Traditional Chinese Medicine,Guangzhou 511400,Guangdong Province,China)

机构地区：[1]广州市番禺区中医院放射科,广东广州511400

出　　处：《中国CT和MRI杂志》2022年第10期153-154,186,共3页Chinese Journal of CT and MRI

基　　金：广东省中医药局科研项目(20151072)。

摘　　要：目的比较MRI、超声及X线诊断退行性膝关节炎临床价值。方法选取2018年1月至2019年12月本院临床考虑诊断为退行性膝关节炎的患者64例共98个受累膝关节,所有患者均行MRI、超声及X线检查,以关节镜最终检出结果为“金标准”,比较三种检查方法诊断效能。结果关节镜术后诊断结果显示,98个受检膝关节中,有82个确诊为退行性膝关节炎,MRI诊断灵敏度、特异度、准确率分别为89.02%、75.00%、86.73%,超声为86.59%、68.79%、83.67%,X线为85.37%、87.50%、85.71%,三种检查方式比较差异无统计学意义(P>0.05);MRI在关节软骨改变、关节积液、滑膜增厚、半月板改变及韧带改变方面检出率分别为82.93%、81.82%、85.94%、90.48%、77.27%,超声分别为87.80%、80.00%、87.50%、76.19、45.45%,均高于X线检查的18.29%、41.82%、18.75%、15.84%、0.00%,且MRI检查在半月板及韧带改变方面的检出率高于超声(P<0.05);MRI检查在腔内有游离体方面的检出率为60.38%高于X线37.74%(P<0.05);X线检查在骨质改变方面的检出率高于超声60.98%(P<0.05)。结论MRI、超声及X线对于诊断退行性膝关节炎的诊断效能无显著差异,但三种检查方式各有侧重点,X线在骨性病变检出率较超声更优,MRI和超声在非骨性病变检出率更优,三种可相互补充。Objective To compare the clinical value of MRI,ultrasound and X-ray in the diagnosis of degenerative osteoarthritis(DOA).Methods A total of 64 patients(98 involved knee joints)clinically confirmed with DOA in the hospital were enrolled between January 2018 and December 2019.All underwent MRI,ultrasound and X-ray examinations.Taking final arthroscopy results as the golden standard,diagnostic efficiency of the three methods was compared.Results The arthroscopy results showed that of the 98 knee joints,there were 82 with DOA.The sensitivity,specificity and accuracy rates of MRI,ultrasound and X-ray in the diagnosis of DOA were(89.02%,75.00%,86.73%),(86.59%,68.79%,83.67%)and(85.37%,87.50%,85.71%),respectively.There was no significant difference in any index among the thee methods(P>0.05).The detection rates of articular cartilage changes,joint effusion,synovial thickening,meniscus changes and ligament changes by MRI and ultrasound were(82.93%,81.82%,85.94%,90.48%,77.27%)and(87.80%,80.00%,87.50%,76.19,45.45%),higher than those by X-ray(18.29%,41.82%,18.75%,15.84%,0.00%).The detection rates of meniscus changes and ligament changes by MRI were higher than those by ultrasound(P<0.05).The detection rate of intracavitary episome by MRI was higher than that by X-ray(60.38%vs 37.74%)(P<0.05).The detection rate of bone changes by X-ray was higher than that by ultrasound(80.49%vs 60.98%)(P<0.05).Conclusion There is no significant difference in diagnostic efficiency of MRI,ultrasound and X-ray for DOA.However,each of them stresses on different aspects.The detection rate of bone lesions by X-ray is better than that by ultrasound,while detection rate of non-bone lesions is better by MRI and ultrasound.And the three can complement each other.

关 键 词：退行性膝关节炎 磁共振成像 超声 X线 临床价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]