CT和MRI在膝关节前交叉韧带撕裂诊断中的应用价值  

Application Value of CT and MRI in the Diagnosis of Anterior Cruciate Ligament Tears in the Knee Joint

作　　者：刘常锋 LIU Changfeng(Department of radiology,Sanshui hospital,Foshan hospital of traditional chinese medicine,Foshan,Guangdong 528100)

机构地区：[1]佛山中医院三水医院放射科,广东佛山528100

出　　处：《中国伤残医学》2024年第5期12-15,29,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨CT和MRI在膝关节前交叉韧带(ACL)撕裂诊断中的应用价值.方法:选取2020年8月-2023年8月佛山中医院三水医院收治的86例ACL撕裂患者为研究对象,所有患者均进行CT和MRI检查.以关节镜检查结果为"金标准",分析两种检测方法在ACL撕裂诊断中的应用价值.结果:86例患者均经关节镜检查,14例正常,30部分撕裂,42例完全撕裂.其中,MRI共检出14例正常,28部分撕裂,40例完全撕裂,诊断准确率为97.67%;CT共检出10例正常,21部分撕裂,34例完全撕裂,诊断准确率为75.58%,MRI诊断准确率高于CT,差异有统计学意义(P<0.05).MRI检测阳性预测值、阴性预测值、灵敏度、特异度、诊断准确率均高于CT检测,差异有统计学意义(P<0.05).影像学表现中,CT检测ACL撕裂呈现低密度表现,患者可见韧带增宽、挛缩、交叉韧带有断裂.MRI检测若可见T1、T2分别为低信号、高信号,表明患者ACL撕裂处于急性发作期;若可见T1信号长过T2,关节韧带扭曲、增粗,且撕裂断端边缘较模糊,或断痕情况显著,表明ACL撕裂处于慢性发作期,信号异常明显.结论:给予ACL撕裂患者MRI进行检测的阳性预测值、阴性预测值、灵敏度、特异度、诊断准确率等指标均高于CT检测,且影像学特征明显,对提高患者诊断准确率有较好应用价值.Objective:To explore the application value of CT and MRI in the diagnosis of anterior cruciate ligament(ACL)tears in the knee joint.Methods:86 patients with ACL tears treated at Sanshui Hospital,Foshan Hospital of Traditional Chinese Medicine,from August 2020 to August 2023 were selected as the research objects.All patients underwent CT and MRI examinations.Arthroscopic examination results were taken as the gold standard to analyze the application value of the two detection methods in the diagnosis of ACL tears.Results:Among the 86 selected patients,all were confirmed by arthroscopy,with 14 normal cases,30 partial tears,and 42 complete tears.Among them,MRI detected 14 normal cases,28 partial tears,and 40 complete tears,with a diagnostic accuracy rate of 97.67%;CT detected 10 normal cases,21 partial tears,and 34 complete tears,with a diagnostic accuracy rate of 75.58%,the diagnostic accuracy rate of MRI was higher than that of CT,and the difference was statistically significant(P<0.05).The positive predictive value,negative predictive value,sensitivity,specificity,and diagnostic accuracy of MRI were higher than those of CT,with statistically significant differences(P<0.05).In terms of imaging performance,CT detection of ACL tears showed low-density manifestations,with ligament widening,contraction,and ACL rupture visible in patients.If MRI shows T1 and T2 signals as low and high,respectively,it indicates that the patient's ACL tear is in the acute phase.If T signal is longer than T2,and the ACL appears twisted,thickened,with blurry or significantly visible tear edges,it indicates that the ACL tear is in the chronic phase,with significant signal abnormalities.Conclusion:The positive predictive value,negative predictive value,sensitivity,specificity,and diagnostic accuracy of MRI for detecting ACL tears are higher than those of CT.Additionally,MRI exhibits clear imaging characteristics,making it valuable for improving diagnostic accuracy in patients.

关 键 词：膝关节前交叉韧带撕裂 CT MRI 诊断应用 影像学表现 

分 类 号：R604[医药卫生—外科学]