核磁共振成像在膝关节退行性骨关节病中的应用价值  

Application value of magnetic resonance imaging in knee joint degenerative osteoarthropathy

作　　者：徐文华 刘晋亮 武康思宇 XUWenhua;LIU Jinliang;WU Kangsiyu(Department of Imaging,Fuzhou Jianqiang Fifth Hospital,Fuzhou,Jiangxi,344000,China;Department of Orthopedics,Fuzhou Jianqiang Fifth Hospital,Fuzhou,Jiangxi,344000,China)

机构地区：[1]抚州健强第五医院影像科,江西抚州344000 [2]抚州健强第五医院骨科,江西抚州344000

出　　处：《当代医学》2022年第35期34-37,共4页Contemporary Medicine

摘　　要：目的探讨核磁共振成像(MRI)在膝关节退行性骨关节病(KOA)中的应用价值。方法回顾性分析2019年6月至2020年6月本院收治的60例KOA患者的临床资料,所有患者均接受X线、MRI及病理检查。比较60例KOA患者X线检查和MRI检查的检查结果、影像学特征、分级结果及关节分型的诊断价值。结果两种检查方法的关节间隙狭窄、骨质增生检出率比较差异无统计学意义;MRI检查韧带退变、关节积液、滑膜增厚、软组织肿胀、半月板变性的检出率均高于X线检查,差异有统计学意义(P<0.05)。X线检查影像显示,关节面局部硬化,关节皮质下部骨质增生,关节间隙对称,骸股间隙变窄,表现出明显的关节间隙狭窄。MRI检查影像显示,关节面粗糙不平,关节间隙的滑膜上皱璧变厚,关节皮质下部骨质增生,相应病变软骨可见大片状的长T1、长T2信号,边界模糊不清;半月板存在条状线性高信号,关节周围软组织肿胀。X线检查、MRI检查分级与病理分级结果比较差异有统计学意义(P<0.05);X线检查分级与病理检查分级一致性较差(Kappa=0.379,P=0.016);MRI检查分级与病理检查分级一致性较好(Kappa=0.784,P<0.001)。以病理检查作为金标准,MRI检查的关节分型的灵敏度、准确度及特异度均高于X线检查,差异有统计学意义(P<0.05)。结论MIR检查在KOA患者诊断中应用效果显著,可完整、清晰的呈现膝关节的变化,提升其关节分型判定的准确度,为患者后续治疗提供参考,值得临床推广应用。Objective To explore the application value of magnetic resonance imaging(MRI)in knee joint degenerative osteoarthropathy.Methods Clinical data of 60 patients with KOA admitted to our hospital from June 2019 to June 2020 were retrospectively analyzed,all patients received X-ray,MRI and pathological examinations.The results of X-ray and MRI examinations,imaging characteristics,grading results and diagnostic value of joint classification of 60 patients with KOA were compared.Results There was no significant difference in the detection rates of joint space stenosis and bone hyperplasia between the two methods.The detection rates of ligament degeneration,joint effusion,synovial thickening,soft tissue swelling and meniscus degeneration in MRI examination were higher than those in X-ray examination,and the difference was statistically significant(P<0.05).X-ray images showed local sclerosis of the articular surface,hyperplasia of the lower articular cortex,symmetrical joint space,narrowing of the skeletal femoral space,showing obvious joint space stenosis.MRI images showed that the articular surface was rough and uneven,the synovium in the joint space was wrinkled and thickened,and the bone hyperplasia in the lower articular cortex was observed,the corresponding diseased cartilage showed large flaky long T1 and long T2 signals,and the boundary was blurred;the meniscus has the striated linear hypersignal,and the soft tissue around the joint shows swelling.The results of X-ray examination,MRI examination and pathological examination had statistical significance(P<0.05);the consistency between X-ray examination and pathological examination was poor(Kappa=0.379,P=0.016).There was a good agreement between MRI grading and pathological grading(Kappa=0.784,P<0.001).With pathological examination as the gold standard,the sensitivity,accuracy and specificity of MRI examination were higher than those of X-ray examination,the difference was statistically significant(P<0.05).Conclusion The application of MIR examination in the diagnos

关 键 词：膝关节退行性骨关节病 核磁共振成像 应用价值 

分 类 号：R684[医药卫生—骨科学]