MRI诊断前交叉韧带损伤假阳性的原因分析  

Analysis of the causes of false positives in MRI diagnosis of anterior cruciate ligament injury

作　　者：薛金伟[1] 林文哲 张新荣[1] 王齐 陈康 王林 XUE Jinwei;LIN Wenzhe;ZHANG Xinrong;WANG Qi;CHEN Kang;WANG Lin(Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;School of Clinical Medicine of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]河北大学附属医院,河北保定071000 [2]河北大学临床医学院,河北保定071000

出　　处：《中国实验诊断学》2025年第4期434-439,共6页Chinese Journal of Laboratory Diagnosis

基　　金：河北省自然科学基金项目(H2021201055)。

摘　　要：目的探究晚期膝骨关节炎(KOA)拟行膝关节单髁置换术患者的髁间窝狭窄程度与MRI诊断前交叉韧带(ACL)损伤假阳性是否具有相关性。方法通过核磁共振结果与术中直视所见对比分析筛选出58例稳定型ACL的患者。测算稳定型ACL患者的髁间窝宽度指数(NWI)和髁间窝形状,将稳定型ACL患者分组为假阳性组13例和正常组45例,进行对比分析观察两组间髁间窝数据是否具有差异。结果MRI诊断正常组与假阳性组不同层面NWI,NWI-a:0.261±0.021、0.242±0.019,NWI-b:0.271±0.045、0.243±0.019,NWI-c:0.288±0.041、0.248±0.012,差异具有统计学意义(P<0.05);假阳性组的A型髁间窝占比明显高于正常组,差异具有统计学意义(P<0.05)。通过ROC曲线得出3个平面的NWI推荐临界值分别为NWI-a=0.260、NWI-b=0.258、NWI-c=0.268。结论髁间窝狭窄程度与晚期KOA患者出现MRI诊断ACL损伤假阳性具有高度相关性,可能是MRI诊断ACL损伤出现假阳性的危险因素。Objective To investigate the correlation between the degree of intercondylar notch stenosis and false positive MRI diagnosis of anterior cruciate ligament injury in patients with advanced knee osteoarthritis undergoing unicompartmental knee arthroplasty.Methods Fifty-eight patients with stable anterior cruciate ligament were screened out by comparing the results of MRI and the results of direct vision during surgery.Measurement the NWI and shape of intercondylar notch in patients with stable ACL.The patients with stable anterior cruciate ligament were divided into false positive group(13cases)and normal group(45cases)to observe whether the data of intercondylar fossa were different between the two groups.Results MRI diagnosis of different levels of NWI in normal and false positive group,NWI-a:0.261±0.021,0.242±0.019,NWI-b:0.271±0.045,0.243±0.019,NWI-c:0.288±0.041,0.248±0.012,The difference was statistically significant(P<0.05);A shape of intercondylar notch accounted for significantly more in the false positive group than in the normal group.The difference was statistically significant(P<0.05).ROC curve indicated that NWI-a=0.260,NWI-b=0.258,NWI-c=0.268were the cutoff values for the intercondylar notch narrowing of the 3sequences.Conclusion Intercondylar notch stenosis is highly correlated with false positive MRI diagnosis of anterior cruciate ligament injury in patients with advanced knee osteoarthritis,which may be a risk factor for false positive MRI diagnosis of ACL injury.

关 键 词：假阳性 前交叉韧带 髁间窝宽度指数 MRI 

分 类 号：R687.4[医药卫生—骨科学]