比较MRI不同序列在早期膝关节软骨损伤分级诊断中的差异  

Differential Comparison of Different MRI Sequences in Grading Diagnosis of Early Knee Cartilage Injury

作　　者：詹晓飞 李小娟 ZHAN Xiaofei;LI Xiaojuan(The Central Hospital of Tongchuan Mining Bureau,Tongchuan Shaanxi 727000)

机构地区：[1]铜川矿务局中心医院,陕西铜川727000

出　　处：《医学临床研究》2024年第11期1719-1721,1725,共4页Journal of Clinical Research

摘　　要：【目的】比较磁共振成像(MRI)不同序列在早期膝关节软骨分级诊断中的差异。【方法】选取2019年1月至2022年1月本院收治的85例早期膝关节软骨损伤患者,分别行MRI三维序列和二维序列检查,以膝关节镜检查结果作为诊断标准,分析并比较不同序列在早期膝关节软骨损伤诊断的效能。【结果】85例患者中共存在130个膝关节软骨损伤,关节镜检查分级显示,0级51个、1级19个、2级26个、3级18个、4级16个;MRI二维序列扫描显示,0级57个、1级16个、2级25个、3级17个、4级15个;MRI三维序列扫描显示,0级52个、1级22个、2级24个、3级17个、4级15个。MRI二维序列与关节镜一致性的结果显示,0~4级Kappa值分别为0.715、0.175、0.341、0.504、0.670。MRI三维序列与关节镜一致性分析显示,0~4级Kappa值分别为0.887、0.566、0.653、0.702、0.817。MRI三维序列诊断膝关节软骨损伤0级、2级、3级、4级的敏感度高于二维序列的敏感度,但差异无统计学意义(P>0.05);三维序列诊断膝关节软骨损伤1级的敏感度高于二维序列,差异有统计学意义(P<0.05)。【结论】MRI三维序列与二维序列均是诊断膝关节软骨损伤的有效检查方法,但MRI三维序列分级诊断膝关节软骨损伤1级的敏感度高于MRI二维序列。【Objective】To compare the differences in early grading diagnosis of knee cartilage using different sequences of magnetic resonance imaging(MRI).【Methods】A total of 85 patients with early knee cartilage injuries admitted to our hospital from January 2019 to January 2022 were selected and underwent MRI three-dimensional and two-dimensional sequence examinations.The results of knee arthroscopy were used as the diagnostic criteria to analyze and compare the efficacy of different sequences in the diagnosis of early knee cartilage injuries.【Results】There were 130 knee cartilage injured lesions in 85 patients.Arthroscopy grading showed that 51 lesions were grade 0,19 were grade 1,26 were grade 2,18 were grade 3,and 16 were grade 4.The MRI two-dimensional sequence scan showed 57 lesions at grade 0,16 at grade 1,25 at grade 2,17 at grade 3,and 15 at grade 4.The MRI three-dimensional sequence scan showed that there were 52 cases at grade 0,22 cases at grade 1,24 cases at grade 2,17 cases at garde 3,and 15 garde at level 4.The consistency results between MRI two-dimensional sequence and arthroscopy showed that the Kappa values for grades 0-4 were 0.715,0.175,0.341,0.504,and 0.670,respectively.The consistency analysis between MRI three-dimensional sequence and arthroscopy showed that the Kappa values for grades 0-4 were 0.887,0.566,0.653,0.702,and 0.817,respectively.The sensitivity of MRI three-dimensional sequence in diagnosing grade 0,2,3,and 4 knee cartilage injuries was higher than those of two-dimensional sequence,but the difference was not statistically significant(P>0.05);The sensitivity of three-dimensional sequence in diagnosing grade 1 knee cartilage injury is higher than that of two-dimensional sequence,and the difference was statistically significant(P<0.05).【Conclusion】Both 3D and 2D MRI sequences are effective diagnostic methods for early knee cartilage injury,but the sensitivity of MRI 3D sequence grading in diagnosing grade 1 knee cartilage injury is higher than that of MRI 2D sequence.

关 键 词：软骨 关节/损伤 磁共振成像/方法 软骨疾病/诊断 膝关节 

分 类 号：R684.76[医药卫生—骨科学]