MRI与膝关节造影CT检查诊断半月板撕裂比较

目的探讨MRI与膝关节造影CT检查、诊断半月板撕裂的优缺点、准确率及相互比较。方法利用（1）CT的高密度分辨率特点，膝关节造影后对比度提高；（2）MRI对水信号高敏感度及软组织分辨率高的特点进行CT和MRI检查。结果85例患者，造影CT准确率96％，MRI准确率95％，MRI同时发现有变性等异常。结论两项检查准确率极高，MRI发现其他病变更多。在MRI尚未开展的基层医院CT造影检查半月板撕裂完全可行，但逐渐将被更具优势的MRI检查取代。     

MRI与膝关节造影CT检查诊断半月板撕裂比较

目的：探讨MRI与膝关节造影CT检查、诊断半月板撕裂的优缺点、准确率及相互比较。方法：利用：（1）CT的高密度分辨率特点，膝关节造影后对比度的提高；（2）MRI对水信号高敏感度及软组织分辨率高的特点进行CT和MRI检查。结果：85例病人，造影CT准确率96％，MRI准确率95％，MRI同时发现有变性等异常。结论：两项检查准确率极高，MRI发现其他病变更多。在MRI尚未开展的基层医院CT造影检查半月板撕裂完全可行，但逐渐将被更具优势的MRI检查取代。     

冈上肌腱撕裂的磁共振诊断

目的　探讨外伤性冈上肌腱撕裂的MRI表现特点、诊断方法和关节腔MR造影的应用价值。方法　 18例均有明确的外伤史 ,开放性手术、关节镜检查或综合诊断最终明确 6例冈上肌腱完全撕裂、9例部分撕裂和 3例无撕裂。所有 18个病例均行常规SE序列MRI检查 ,另追加FE序列成像 11例、关节腔MR造影 9例、脂肪抑制序列成像 5例。结果　常规SE序列诊断冈上肌腱撕裂的准确率为 5 0 % (9/18) ,部分病例追加关节腔MR造影后准确率提高至 72 .2 % ;FE序列和脂肪抑制序列可提高检出病灶的敏感性。结论　冈上肌腱MRI诊断尚需采用SE序列、FE序列、脂肪抑制、关节腔造影等多种MR成像方法。     

膝关节半月板撕裂的MRI与关节镜诊断对照研究

目的:比较分析半月板撕裂的MRI征象与关节镜下表现,提高半月板撕裂的MRI诊断准确率.方法:选取本院76个半月板病例,对其进行MRI征象分析并诊断,所有病例2周内行关节镜检查,将其结果与MRI诊断结果进行对比.结果:本组病例,MRI诊断30个半月板为Ⅲ级损伤;关节镜诊断28个半月板为撕裂即Ⅲ级损伤.MRI与关节镜诊断一致的撕裂半月板个数为22个,MRI诊断为可疑撕裂但关节镜诊断为阴性的半月板个数为8个,MRI诊断为阴性但关节镜诊断为撕裂的半月板为6个.本组病例半月板撕裂的MRI诊断的灵敏性为79％,特异性为93％.结论:从半月板撕裂的MRI征象中,分析假阳性及假阴性病例,找出提高MRI对半月板撕裂诊断准确率的对策为:MRI诊断应结合患者的临床症状,对于半月板内高信号的性质判断应准确,防止周围韧带被误认为半月板撕裂信号,对于线状高信号的层数判断应准确,对于半月板变形与弥漫性高信号的分析应结合伴随征象,对于桶柄状撕裂的征象应观察清楚.     

半月板损伤的磁共振诊断与关节镜结果对照分析

【目的】进一步了解磁共振成像(MRI)对膝关节半月板损伤的诊断价值。【方法】对76(膝)例临床拟诊半月板损伤的MRI和关节镜检查结果作对照分析。【结果】76膝MRI确诊半月板损伤．关节镜发现半月板撕裂61个膝关节．与MRI诊断半月板Ⅲ级信号59个膝关节的结果相近。【结论】MRI对膝关节半月板损伤诊断极有价值,特别是半月板内Ⅲ级信号是诊断半月板撕裂的可靠征象。     

半月板损伤的磁共振诊断与关节镜检查对照分析

目的探讨MRI和关节镜在半月板损伤中的诊断价值。方法对60（膝）例临床拟诊半月板损伤的MRI和关节镜检查结果作对照分析。结果60膝MRI确诊半月板损伤,关节镜发现半月板撕裂51个膝关节,与MRI诊断半月板Ⅲ级信号49个膝关节的结果相近。结论MRI是诊断半月板破裂极有价值的无创方法,是膝关节镜术前的重要检查。MRI与临床诊断相结合可提高半月板撕裂伤的诊断率,避免不必要的关节镜手术。     

膝关节半月板损伤磁共振成像诊断与关节镜检查对比研究

目的探讨MRI在膝关节半月板损伤诊断中的应用价值。方法回顾性分析70例同时接受MRI和关节镜检查的膝关节损伤患者的病历资料。共涉及86个膝关节,左膝27例,右膝40例,双膝同时发病19例。所有患者均有外伤史,主要表现为膝关节疼痛、肿胀、功能受限及绞锁。结果按照Stoller等半月板损伤MRI分级标准,0级8膝,Ⅰ级2膝,Ⅱ级16膝,Ⅲ级60膝。经关节镜检查,MRI检查诊断为0级的8膝膝关节中有2膝为外侧半月板边缘撕裂;MRI检查诊断为Ⅱ级和Ⅲ级半月板损伤的膝关节中分别有1膝经关节检查证实其异常高信号为滑膜增生而非半月板损伤。经Kappa检验,MRI检查和关节镜诊断半月板损伤结果的一致性较好（Kappa=0．724,P=0．000）。MRI诊断半月板损伤的敏感度为97．44％,特异度为75％,准确率为95．35％。结论MRI检查和关节镜诊断半月板损伤结果的一致性良好,敏感度和准确率高,安全无创,应作为临床诊断半月板损伤的首选方法。     

膝半月板和关节软骨损伤MRI诊断效果分析

目的:分析膝半月板和关节软骨损伤MRI的诊断效果。方法:选取2018年12月—2020年9月我院骨科收治的膝半月板和关节软骨损伤患者110例作为本次研究的对象,均接受了M R I与CT检查。以关节镜检查结果为金标准,比较两种检查方式的诊断准确率。结果:M R I诊断膝半月板和关节软骨损伤的准确率高于CT,MRI对Ⅳ期膝半月板损伤的检出率高于CT,对Ⅲ期关节软骨损伤的检出率高于CT,差异具有统计学意义(P<0.05)。结论:M R I诊断膝半月板和关节软骨损伤的准确率高于CT检查,可以较为准确地诊断出分期较高的膝半月板和关节软骨损伤,可以为临床诊疗提供有力的依据。     

MRI对胫骨平台骨折患者半月板损伤诊断价值分析

目的:探讨磁共振成像(MRI)对胫骨平台骨折患者半月板损伤诊断价值。方法:选取2020年1月—2023年1月徐州市铜山区中医院收治的胫骨平台骨折患者46例,均行MRI检查,以关节镜检查或手术结果为“金标准”,分析MRI对胫骨平台骨折患者半月板损伤的诊断价值。结果:以关节镜或手术检查为金标准,MRI诊断胫骨平台骨折患者半月板损伤的灵敏度为92.50%(37/40)、特异度为83.33%(5/6)、准确率为91.30%(42/46);46例胫骨平台骨折患者经关节镜检查有40例半月板损伤,MRI诊断半月板损伤Ⅰ级、Ⅱ级、Ⅲ级的准确率分别为71.43%(5/7)、95.45%(21/22)、90.91%(10/11);关节镜或手术检查共11个半月板撕裂,其中水平撕裂4例,斜行撕裂4例,纵行撕裂3例,MRI诊断水平撕裂、斜行撕裂、纵行撕裂的准确率分别为100.00%、75.00%、100.00%。结论:MRI对胫骨平台骨折患者半月板损伤具有较高诊断效能,能准确评估半月板损伤程度及撕裂情况,为手术治疗提供有效指导。     

关节镜与MRI诊断膝半月板损伤的对比研究

目的探讨膝关节半月板损伤MRI检查对指导关节镜下诊断及手术治疗的意义。方法 231例(245膝)经膝关节MRI诊断为膝关节半月板损伤病例,包括退变性及外伤性半月板损伤,按半月板损伤MRI诊断标准进行分级,将结果与关节镜下探查结果进行对比。结果 MRI诊断Ⅰ级损伤25膝(退变组19膝,外伤组6膝),关节镜检查退变性损伤19膝均未见半月板破损;Ⅱ级损伤133膝(退变组72膝,外伤组61膝),关节镜检查退变性损伤68膝半月板破裂,外伤性损伤48膝半月板破裂;Ⅲ级损伤87膝(退变组48膝,外伤组39膝),关节镜检查退变性损伤42膝半月板破裂,外伤性损伤31膝半月板破裂。以关节镜检查为标准,计算MRI诊断准确率,Ⅰ级损伤:退变组为0;Ⅱ级损伤:退变组为94.4%,外伤组为78.7%;Ⅲ级损伤:退变组为87.5%,外伤组为79.5%。MRI诊断总体准确率79.1%。结论 MRI是膝关节镜术前的重要检查,结合临床症状及体征,对指导半月板损伤手术治疗有重要作用。     

外伤性肩袖损伤MR平扫与MR关节造影的诊断价值

目的：评价ＭＲ平扫和ＭＲ关节造影在外伤性肩袖损伤中的诊断价值。材料与方法：经关节镜证实的外伤性肩袖撕裂２５例,其中左肩１０例,右肩１５例,男性１９例,女性６例;行常规的ＭＲ平扫后,在透视下穿刺肩关节腔注入１５～２０ｍｌ的混合性造影剂,在４５分钟内完成再一次的ＭＲ扫描。结果：关节镜证实肩袖的完全撕裂、部分撕裂分别为１０例和１５例。在肩袖完全撕裂中,ＭＲ平扫和ＭＲＡ诊断的准确率分别为８０％（８／１０）     

应用MR 仿真内镜诊断膝半月板病变

目的研究半月板ＭＲ仿真内镜（ＭＭＲＶＥ）在诊断膝关节Ｓｔｏｌｌｅｒ分级３级半月板损伤中的临床应用价值和方法。方法５９例采用快速自旋回波序列（ＦＳＥ）,获得了质子密度像,Ｔ２加权像;８例应用马根维显（Ｍａｇｅｎｖｉｓｔ）膝关节造影ＭＲＩ获得ＦＳＥ序列Ｔ１加权像。应用工作站对图像数据进行ＭＭＲＶＥ重建。结果本组ＭＭＲＶＥ的敏感度９６％,准确度９３％,特异度７３％。ＭＭＲＶＥ可以显示常规ＭＲＩ上难以显示     

Imaging the postoperative meniscus

Patients who have undergone meniscal repair or resection and who develop new symptoms frequently are referred for MR imaging. In the postoperative meniscus, however, the standard MR imaging criteria for meniscal tears cannot be applied to diagnose recurrent or residual tears because signal and shape abnormalities are expected postoperative findings. This article reviews the MR imaging findings that can be used for diagnosing recurrent tears and demonstrates the usefulness of MR arthrography in the evaluation of the postoperative meniscus.     

The value of ultrasonography in the detection of meniscal tears diagnosed by magnetic resonance imaging

OBJECTIVE: To evaluate the diagnostic value of ultrasonography in meniscal tears that were diagnosed by magnetic resonance imaging (MRI). DESIGN: Twenty-seven knees with meniscal tears and 14 knees without tears on MRI were prospectively evaluated. A radiologist performed the ultrasonography and evaluated the presence and locations of the meniscal tears. MRI was used as the reference standard. RESULTS: Twenty-nine menisci with tears and 53 menisci without tears were identified by MRI. Twenty-two tears were in the medial menisci, and seven tears were in the lateral menisci. In the 29 meniscal tears, the ultrasonographic diagnosis was correct in 25 (86.2%) and incorrect in 4 (13.8%) menisci. In the 53 menisci without tears, the ultrasonographic diagnosis was correct in 45 (84.9%) and incorrect in 8 (15.1%) menisci. Ultrasonography showed a sensitivity, specificity, accuracy, and positive and negative predictive values for meniscal tears of 86.2%, 84.9%, 85.4%, 75.8%, and 91.8%, respectively. Of the four intracapsular injuries observed by MRI in injured knees, an osteochondritis dessecans was only observed by ultrasonography. CONCLUSIONS: Ultrasonography is an accurate imaging study for diagnosing meniscal tears. The results correlated with those obtained by MRI; this suggests that ultrasonography can be a useful imaging modality in uninjured knees.     

MR在膝关节外伤中的诊断价值

本文对20例膝关节外伤的MR检查作了研究，其中9例施行了关节手术，并与常规X线检查进行了对照，MR显示半月板撕裂及前十字韧带撕裂的正确率均为90％。对膝关节不完全骨折、骨挫伤及软骨骨折的显示，明显优于常规X线检查。     

Current concepts and controversies in meniscal imaging

Analyzing meniscal abnormalities on MR images depends on a thorough understanding of the normal appearance of meniscal structures and on strict adherence to the MR imaging criteria for meniscal tears. When proper MR imaging technique is followed, meniscal tears can be diagnosed more acutely than with clinical examination alone, even in the presence of associated ligament injuries. The value of MR imaging lies in its ability to reveal details of meniscal tears, including location, morphology, length, depth, and possible stability. If this MR imaging information can be synthesized, it will dramatically affect treatment planning by helping to predict meniscal tears that are potentially reparable and tears that might not need surgical intervention.     

MR imaging of the meniscus: review, current trends, and clinical implications

MR imaging is the preferred imaging modality for evaluating the meniscus. Overall, when strict criteria are followed, it is accurate in diagnosing meniscal tears in patients who have not had prior meniscal surgery. However, an accurate interpretation requires a through knowledge of the normal meniscal anatomy, common meniscal variants, and common diagnostic pitfalls. In this article, the author emphasizes the importance of describing meniscal tears properly and discusses treatment options. Diagnosing a recurrent tear is more complicated in patients who have had prior partial meniscal resection or repair, and the use of MR arthrography in this group of patients is discussed. Recent developments in areas such as 3 T and parallel imaging offer promise for accurate meniscal evaluation with even shorter scan times.     

Meniscal tears--comparison of arthrography, CT, and MRI

A total of 1750 knees were prospectively evaluated using a high-resolution noninvasive axial computed tomography (CT) scanning technique. A total of 203 knees underwent subsequent arthroscopic or arthrographic evaluation. In this group, the sensitivity of CT for the detection of a torn meniscus was 88.5%; the specificity was 95.5%; and the accuracy was 91.5%. An additional 270 knees were prospectively evaluated by both CT and magnetic resonance imaging (MRI) to determine the ability of both techniques to characterize knee menisci in patients believed to have meniscal tears. Of these knees, 94 were subsequently examined by arthroscopy. In this group, the overall accuracy of MRI for detecting a torn meniscus was 89.5% and for CT it was 92.2%. Properly performed, both CT and MRI are accurate and effective methods for noninvasively evaluating meniscal abnormalities in the acutely injured knee. The protocol for CT and MRI meniscus imaging as well as interpretation are presented in addition to their relative roles with respect to arthrography and arthroscopy.