MRI脂肪抑制技术对膝关节隐匿性骨折的诊断价值  

Diagnostic value of fat suppression MRI for occult fractures of the knee

作　　者：董晚亭 王浩东[1] 罗铧 潘小文[1] 易雪冰[1] DONG Wanting;WANG Haodong;LUO Hua;PAN Xiaowen;YI Xuebing(Department of Medical Imaging,Sichuan Province Orthopaedic Hospital,Chengdu 610000,China)

机构地区：[1]四川省骨科医院医学影像科,四川成都610000

出　　处：《中国医学物理学杂志》2023年第10期1237-1240,共4页Chinese Journal of Medical Physics

基　　金：四川省中医药管理局基金(2021MS330)。

摘　　要：目的:探讨MRI脂肪抑制技术对膝关节隐匿性骨折的诊断价值。方法:回顾性分析118例高度怀疑膝关节隐匿性骨折患者的相关资料,患者均接受CT、MRI脂肪抑制序列检查,其后采用手术或者关节镜证实患者骨折病情,分析CT、MRI对膝关节隐匿性骨折的诊断准确性。结果:MRI对韧带损伤、半月板损伤以及关节腔积液等膝关节隐匿性骨折损伤类型检出率分别为25.42%、34.75%、27.14%,均显著高于CT的6.78%、15.25%、12.71%(P<0.05);MRI对骨折塌陷及水平错位检出率分别为61.02%、58.47%,均高于CT的40.68%、38.14%,其中MRI对1、2级骨折塌陷及水平错位检出率均高于CT,差异有统计学意义(P<0.05);选择手术或者关节镜检查结果作为诊断膝关节隐匿性骨折的金标准,MRI诊断膝关节隐匿性骨折的灵敏度与准确度分别为95.60%、92.37%,均显著高于CT的78.02%、81.36%(P<0.05)。结论:相对于CT检查,MRI诊断膝关节隐匿性骨折的灵敏度与准确度较高,其在患者微小骨折塌陷及水平错位方面的检查优势明显。Objective To explore the value of fat suppression MRI in the diagnosis of occult fractures of the knee.Methods The clinical data of 118 patients highly suspected of occult fractures of the knee were analyzed retrospectively.All patients underwent CT and fat suppression MRI examinations,and were confirmed by surgery or arthroscopy.The diagnostic accuracies of CT and MRI were analyzed.Results The detection rates of ligament injury,meniscus injury and joint effusion using MRI were higher than those using CT(25.42%vs 6.78%,34.75%vs 15.25%and 27.14%vs 12.71%;all P<0.05).The detection rates of fracture collapse and horizontal dislocation using MRI were 61.02%and 58.47%,higher than those using CT(40.68%and 38.14%),and the detection rates of grade 1 and 2 fracture collapse and horizontal dislocation were significantly higher than those using CT(P<0.05).With the results of surgery or arthroscopy as the golden standard,MRI and CT had sensitivity of 95.60%vs 78.02%and accuracy of 92.37%vs 81.36%for diagnosing occult fractures of the knee(P<0.05).Conclusion Compared with CT,MRI has a high sensitivity and accuracy for diagnosing occult fractures of the knee,and is advantageous in detecting small fracture collapse and horizontal dislocation.

关 键 词：磁共振成像 脂肪抑制技术 膝关节隐匿性骨折 

分 类 号：R816.8[医药卫生—放射医学]