3.0T MRI和关节镜检查对膝关节软骨病变的评估  

Evaluation of Knee Cartilage Lesions by 3.0T Magnetic Resonance Imaging and Arthroscopy

作　　者：鄢含坤 陈文革 夏正东 杨朝晖 YAN Han-kun;CHEN Wen-ge;XIA Zheng-dong;YANG Zhao-hui(Department of Joint Surgery,Affiliated Hospital of Hubei University for Nationalities,Enshi 445000,Hubei Province,China)

机构地区：[1]湖北民族大学附属民大医院关节外科,湖北恩施445000

出　　处：《中国CT和MRI杂志》2023年第7期166-168,共3页Chinese Journal of CT and MRI

基　　金：湖北省卫生健康委员会项目(WJ2019F140)。

摘　　要：目的 探讨3.0T磁共振成像(Magnetic Resonance Imaging,MRI)和关节镜检查对膝关节软骨病变的效果。方法 选取2019年10月至2021年10月80名于本院接受半月板部分切除术的患者,所有均行膝关节1.5T MRI、3.0-T MRI和关节镜Outerbridge和ICRS分级检查。以关节镜的诊断作为标准,评估1.5T MRI、3.0-T MRI诊断的灵敏度、特异度和准确度。结果 根据关节镜分级评估结果显示,在288次关节面评估中,113次(39%)关节面评估被归类为疾病阳性(Ⅱ至Ⅳ级)。与关节镜Outerbridge分级相比,1.5 T MRI分级诊断关节软骨病变的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为73.83%、81.22%、69.91%、84.00%和78.47%,Kappa值为0.544,与关节镜Outerbridge分级具有一定一致性;与关节镜Outerbridge分级相比,1.5 T MRI分级诊断关节软骨病变的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为65.32%、80.49%、71.68%、75.43%和73.96%,Kappa值为0.463,与关节镜Outerbridge分级具有一定一致性。与关节镜Outerbridge分类相比,3.0 T MRI分级诊断关节软骨病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为81.42%、81.14%、73.60%、87.12%和81.25%,Kappa值为0.614,与关节镜Outerbridge分类具有较好的一致性;与关节镜ICRS分级相比,3.0 T MRI分级诊断关节软骨病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为76.99%、78.29%、69.60%、84.05%和77.78%,Kappa值为0.543,与关节镜Outerbridge分类具有较好的一致性。结论 相比于1.5 T MRI,3.0 T MRI和关节镜检查是一种非侵入性工具,在评估膝关节软骨病变方面具有更好的诊断价值。Objective To explore the evaluation effect of 3.0T magnetic resonance imaging(MRI)and arthroscopy for knee cartilage lesions.Methods A total of 80 patients undergoing partial meniscectomy in the hospital were enrolled between October 2019 and October 2021.All underwent examinations of knee 1.5T MRI,3.0T MRI,arthroscopic Outerbridge and ICRS grading.Taking arthroscopic diagnosis as the standard,diagnostic sensitivity,specificity and accuracy of 1.5T MRI and 3.0T MRI were evaluated.Results According to evaluation results of arthroscopic grading,in the 288 times of articular surface evaluation,there were 113(39%)times with positive lesions(grades Ⅱ-Ⅳ).Compared with arthroscopic Outerbridge grading,sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of 1.5T MRI grading in the diagnosis of articular cartilage lesions were 73.83%,81.22%,69.91%,84.00%,78.47%and 0.544,with certain consistency with arthroscopic Outerbridge grading.Compared with arthroscopic ICRS grading,sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of 3.0T MRI grading in the diagnosis of articular cartilage lesions were 65.32%,80.49%,71.68%,75.43%,73.96%and 0.463,with certain consistency with arthroscopic ICRS grading.Compared with arthroscopic Outerbridge grading,sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of 3.0T MRI grading in the diagnosis of articular cartilage lesions were 81.42%,81.14%,73.60%,87.12%,81.25%and 0.614,with good consistency with arthroscopic Outerbridge grading.Compared with arthroscopic ICRS grading,sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of 3.0T MRI grading in the diagnosis of articular cartilage lesions were 76.99%,78.29%,69.60%,84.05%,77.78%and 0.543,with good consistency with arthroscopic Outerbridge grading.Conclusion Compared with 1.5T MRI,3.0T MRI and arthroscopy are non-invasive tools,which have better di

关 键 词：3.0 T磁共振成像 关节镜检查 膝关节 软骨病变 

分 类 号：R684.7[医药卫生—骨科学]