MRI在评估膝关节骨性关节炎软骨损害程度及临床分期的应用研究  

Application of MRI in Evaluating the Severity of Cartilage Damage and Clinical Staging of Knee Osteoarthritis

作　　者：郭浪山 张慧丽 董从松 刘洋[1] 陈洁[1] Guo Lang-shan;Zhang Hui-li;Dong Cong-song;Liu Yang;Chen Jie(Imaging Department,Yancheng Clinical Medical College,Nanjing Medical University,Yancheng Third People's Hospital,Yancheng 224008,Jiangsu Province,China;School of Medical Imaging,Jiangsu Medical Vocational College,Yancheng 224005,Jiangsu Province,China)

机构地区：[1]南京医科大学盐城临床医学院、盐城市第三人民医院影像科,江苏盐城224008 [2]江苏医药职业学院医学影像学院,江苏盐城224005

出　　处：《中国CT和MRI杂志》2023年第12期167-169,共3页Chinese Journal of CT and MRI

基　　金：盐城市科技计划项目(YK2021014)。

摘　　要：目的探讨磁共振成像(MRI)在评估膝关节骨性关节炎(KOA)软骨损害程度及临床分期的应用价值。方法对我院2020年1月至2022年12月62例KOA患者的资料进行回顾性分析,所有患者均行MRI检查,以关节镜检查结果为“金标准”,分析MRI诊断KOA患者软骨损害程度及临床分期的准确率。结果关节镜检查显示,62例KOA患者存在182个软骨面损伤,损害关节分布:内侧关节面胫骨内髁33个(18.13%),股骨内髁32个(17.58%);外侧关节面胫骨外髁8个(4.40%),股骨外髁10个(5.49%);髌股关节面股骨滑车45个(24.73%),髌骨54个(29.67%);软骨损害程度:1级软骨损害54个(29.67%),2A级软骨损害40个(21.98%),2B级软骨损害51个(28.02%),3级软骨损害37个(20.33%);临床分期:初期13例,早期10例,中期22例,晚期17例。MRI诊断KOA患者软骨损害程度的总准确率为87.36%(159/182),诊断1级、2A级、2B级、3级软骨损害程度的准确率分别为83.33%(45/54)、90.00%(36/40)、84.31%(43/51)、94.59%(35/37)。MRI诊断KOA患者临床分期的总准确率为80.65%(/62),诊断初期、早期、中期、晚期的准确率分别为76.92%(10/13)、80.00%(8/10)、77.27%(17/22)、88.24%(15/17)。结论MRI对KOA具有较高的诊断价值,能指导临床评估软骨损害程度及临床分期。Objective To explore the application value of magnetic resonance imaging(MRI)in evaluating the severity of cartilage damage and clinical staging of knee osteoarthritis(KOA).Methods The data of 62 patients with KOA in the hospital were retrospectively analyzed between January 2020 and December 2022.All underwent MRI examination.Taking arthroscopy results as the golden standard,accuracy of MRI in evaluating the severity of cartilage damage and clinical staging in KOA patients was analyzed.Results Arthroscopy showed that there were 182 cartilage surface damage in the 62 patients with KOA,including 33(18.13%)in tibial condyle of medial articular surface,32(17.58%)in medial femoral condyle,8(4.40%)in tibial condyle of lateral articular surface,10(5.49%)in lateral femoral condyles,45(24.73%)in femoral trochlea of patellofemoral articular surface and 54(29.67%)in patella.In terms of different severity of cartilage damage,there were 54(29.67%)lesions with cartilage damage at grade 1,40(21.98%)lesions at grade 2A,51(28.02%)lesions at grade 2B and 37(20.33%)lesions at grade 3.In terms of clinical staging:there were 13 cases,10 cases,22 cases and 17 cases in preliminary,early,middle and late stages,respectively.The total accuracy rate of MRI in the diagnosis of the severity of cartilage damage was 87.36%(159/182),and accuracy rates in the diagnosis of cartilage damage at grade 1,grade 2A,grade 2B and grade 3 were 83.33%(45/54),90.00%(36/40),84.31%(43/51)and 94.59%(35/37),respectively.The total accuracy rate of MRI in the diagnosis of clinical staging of KOA patients was 80.65%(/62),and its accuracy rates in the diagnosis of preliminary,early,middle and late stages were 76.92%(10/13),80.00%(8/10),77.27%(17/22)and 88.24%(15/17),respectively.Conclusion MRI has high diagnostic value for KOA,which can guide clinical evaluation of cartilage damage severity and clinical staging.

关 键 词：膝关节骨性关节炎 磁共振成像 软骨损害程度 临床分期 

分 类 号：R445.2[医药卫生—影像医学与核医学]