MRI与CT在膝关节损伤诊断中的临床应用  

Diagnostic value of MRI and MSCT in traumatic knee joint injury in adults

作　　者：杜蕊[1] 宋春华[1] 许梓童[1] 张铁[1] 张铁亮[2] DU Rui;SONG Chunhua;XU Zitong;ZHANG Tie;ZHANG Tieliang(Department of Medical Imaging,Liangxiang Hospital,Fangshan District,Beijing 102401,China;Department of Imaging,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]北京市房山区良乡医院医学影像科,北京102401 [2]新疆医科大学第一附属医院影像科,新疆乌鲁木齐830000

出　　处：《医学影像学杂志》2023年第7期1240-1243,共4页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2018D01C219)。

摘　　要：目的探讨MRI与CT在膝关节损伤诊断中的临床应用价值。方法选取膝关节损伤患者96例,行MRI和MSCT检查,将手术或关节镜结果作为金标准,比较MRI和MSCT的诊断效能。结果经手术或关节镜最终确诊阳性患者84例,阴性12例;MSCT检查最终确诊阳性74例,阴性22例;MRI检查最终确诊阳性83例,阴性13例。MRI的诊断准确度、特异度、敏感度、阳性及阴性预测值较MSCT高(P<0.05)。MSCT最终确诊的74例患者中,胫骨髁间嵴骨折14例,髌骨骨折15例,股骨内侧髁骨折10例,内上髁骨折8例,股骨外侧髁骨折6例,外上髁骨折5例,胫骨平台骨折10例,股骨远端及胫骨近端粉碎性骨折6例,这些骨折患者检查期间均有清晰骨折线存在。MRI最终确诊的83例患者当中,胫骨髁间嵴骨折16例,髌骨骨折16例,股骨内侧髁骨折13例,内上髁骨折9例,股骨外侧髁7例,外上髁骨折6例,胫骨平台骨折10例,股骨远端及胫骨近端粉碎性骨折6例,观察到有骨折线且伴随长T_(1)和T_(2)信号。将手术或关节镜结果作为金标准,MRI检查对于骨折线、骨折附近软组织损伤及关节囊积液的检出率高于MSCT检查(P<0.05)。结论与MSCT相比,成人外伤所致膝关节损伤采取MRI诊断效能较高,可清晰提供损伤位置影像学特征,明确损伤分型,为临床诊治带来客观、准确的参考依据。Objective To explore the clinical application value of MRI and CT in the diagnosis of knee joint injury.Methods MRI and MSCT were performed in 96 patients with knee injury.The results of surgery or arthroscopy were used as the gold standard to compare the diagnostic efficacy of MRI and MSCT.Results 84 cases were confirmed positive by surgery or arthroscopy,and 12 cases were negative;MSCT examination ultimately confirmed positive in 74 cases and negative in 22 cases;MRI examination ultimately confirmed positive in 83 cases and negative in 13 cases.The diagnostic accuracy,specificity,sensitivity,positive and negative predictive values of MRI were higher than those of MSCT(P<0.05).Among the 74 patients finally diagnosed by MSCT,14 were tibial intercondylar ridge fractures,15 were patellar fractures,10 were medial femoral condylar fractures,8 were medial epicondylar fractures,6 were lateral femoral condylar fractures,5 were lateral epicondylar fractures,10 were tibial plateau fractures,and 6 were comminuted fractures of the distal and proximal tibia.All of these fractures had clear fracture lines during the examination.Among the 83 patients finally diagnosed by MRI,16 were tibial intercondylar ridge fractures,16 were patellar fractures,13 were medial femoral condyles,9 were medial epicondylar fractures,7 were lateral femoral condyles,6 were lateral epicondylar fractures,10 were tibial plateau fractures,and 6 were comminuted fractures of distal femur and proximal tibia.Fracture lines with long T_(1) and T_(2) signals were observed.Using the results of surgical arthroscopy as a standard,the detection rate of MRI for fracture line,soft tissue injury near the fracture,and joint capsule effusion was higher than that of MSCT(P<0.05).Conclusion Compared with MSCT,MRI is more effective in the diagnosis of knee joint injury caused by adult trauma,which can clearly provide the imaging features of the injury location,clarify the injury classification,and provide objective and accurate reference for clinical diagnosis and treatm

关 键 词：膝关节损伤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R681[医药卫生—诊断学]