“胫骨平台比”和前内侧半月板突出度在后交叉韧带损伤诊断中的应用对比观察  

A comparative analysis of application of the"tibial plateau ratio"and the protrusion of the anterior medial meniscus in diagnosis of posterior cruciate ligament injuries

作　　者：梁晓远 滕元君[1] 向德剑 牛永康 移植 詹宏伟 耿彬[2] 夏亚一[2] LIANG Xiaoyuan;TENG Yuanjun;XIANG Dejian;NIU Yongkang;YI Zhi;ZHAN Hongwei;GENG Bin;XIA Yayi(The Second Clinical Medical College,Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]兰州大学第二医院骨科·甘肃省骨科临床医学研究中心·甘肃省智能骨科行业技术中心

出　　处：《山东医药》2024年第33期40-43,共4页Shandong Medical Journal

基　　金：甘肃省自然科学基金资助项目(22JR5RA956,22JR5RA943)。

摘　　要：目的对比观察“胫骨平台比”、前内侧半月板突出度在后交叉韧带(PCL)损伤诊断中的应用效果。方法经关节镜检查确诊PCL损伤的患者69例,记为PCL损伤组;无PCL损伤的其他膝关节疾病患者72例,记为PCL正常组。两组患者均接受膝关节MRI检查,使用RadiAnt Dicom Viewer测量检查图像中的前内侧半月板突出度、胫骨平台比。采用受试者工作特征曲线(ROC)分析胫骨平台比和前内侧半月板突出度的诊断效能,以计算最大约登(Youden)指数法确定截断值。结果PCL损伤组胫骨平台比、前内侧半月板突出度分别为0.38(0.31,0.41)、3.30(2.67,3.94)mm,PCL正常组胫骨平台比、前内侧半月板突出度分别为0.50(0.44,0.54)、2.17(1.83,2.48)mm,两组相比,P均<0.05。胫骨平台比诊断PCL损伤的AUC为0.87,取截断值为0.43时,胫骨平台比诊断PCL损伤的敏感度为0.86、特异度为0.82。前内侧半月板突出度诊断PCL损伤的AUC为0.88,取截断值为2.86 mm时,前内侧半月板突出度诊断PCL损伤的敏感度为0.71、特异度为0.92。结论胫骨平台比、前内侧半月板突出度在PCL损伤诊断中的效能相当。Objective To compare the diagnostic efficacy of the"tibial plateau ratio"and the protrusion of the anterior medial meniscus(PAMM)in diagnosing posterior cruciate ligament(PCL)injuries.Methods Sixty-nine patients with arthroscopically confirmed PCL injuries were classified as the PCL injury group,while 72 patients with other knee joint disorders,without PCL injuries,were designated as the PCL normal group.Patients in both groups underwent knee MRI examination,during which the PAMM and the tibial plateau ratio were quantified using the RadiAnt DICOM Viewer.Receiver operating characteristic(ROC)analysis was conducted to assess the diagnostic efficacy of the tibial plateau ratio and PAMM,and the cut-off value was determined by calculating the maximum Youden index method.Results In the PCL injury group,the tibial plateau ratio and PAMM were 0.38(0.31,0.41)and 3.30(2.67,3.94)mm,respectively;in contrast,the corresponding measurements in the PCL normal group were 0.50(0.44,0.54)and 2.17(1.83,2.48)mm,with statistically significant differences between these two groups(all P<0.05).The area under the curve(AUC)of the tibial plateau ratio in diagnosing PCL injuries was 0.87,reflecting a sensitivity of 0.86 and a specificity of 0.82 at a cut-off value of 0.43.In comparison,the AUC of PAMM in diagnosing PCL injuries was 0.88,demonstrating a sensitivity of 0.71 and a specificity of 0.92 at a cut-off value of 2.86 mm.Conclusion The diagnostic efficacy of the tibial plateau ratio and PAMM in PCL injuries is equivalent.

关 键 词：胫骨平台比 前内侧半月板突出度 后交叉韧带 磁共振检查 

分 类 号：R686.5[医药卫生—骨科学]