MRI对膝关节盘状半月板及其损伤的诊断价值

目的:探讨MRI对膝关节盘状半月板及其损伤的诊断价值。方法:回顾性分析89例(151个膝关节)盘状半月板及其损伤的MRI、关节镜及手术资料。结果:89例盘状半月板中,88例(150个膝关节)为外侧盘状半月板,1例(1个膝关节)为内侧盘状半月板,表现为半月板增大、增宽、增厚,矢状面上可见≥3个层面前后角相连,冠状面髁间棘层面半月板宽度>15mm。本组中81例(138个膝关节)伴半月板损伤,发生率为91.40%,MRI表现为半月板不同程度变性或撕裂。与膝关节镜及手术对照,MRI图像对半月板损伤诊断的特异度为92.31%、敏感度为99.28%;对Ⅰ～Ⅱ级半月板损伤诊断的符合率为95.00%;对Ⅲ级半月板损伤诊断的符合率为98.98%。结论:MRI能准确判断盘状半月板类型及其损伤的范围和程度,是诊断盘状半月板及其损伤的最佳检查方法。     

The value of MRI in the diagnosis of injury of discoid meniscus

目的:探讨MRI对膝关节盘状半月板及其损伤的诊断价值.方法:回顾性分析89例(151个膝关节)盘状半月板及其损伤的MRI、关节镜及手术资料.结果:89例盘状半月板中,88例(150个膝关节)为外侧盘状半月板,1例(1个膝关节)为内侧盘状半月板,表现为半月板增大、增宽、增厚,矢状面上可见≥3个层面前后角相连,冠状面髁闻棘层面半月板宽度>15 mm.本组中81例(138个膝关节)伴半月板损伤,发生率为91.40%,MRI表现为半月板不同程度变性或撕裂.与膝关节镜及手术对照,MRI图像对半月板损伤诊断的特异度为92.31%、敏感度为99.28%,对I～Ⅱ级半月板损伤诊断的符合率为95.00%;对Ⅲ级半月板损伤诊断的符合率为98.98%.结论:MRI能准确判断盘状半月板类型及其损伤的范围和程度,是诊断盘状半月板及其损伤的最佳检查方法.     

膝关节半月板损伤的MRI诊断

目的：探讨膝关节半月板损伤的MRI临床诊断价值。方法：回顾性分析108例膝关节半月板损伤的MRI表现。并按Mink和Fischer方法进行分级。结果：108例216个半月板中有159个损伤，其中I级损伤36个，Ⅱ级损伤78个。Ⅲ级损伤45个(经手术证实)。结论：MRI对膝关节半月板损伤具有很高的诊断价值及临床意义，可以清晰地显示半月板的形态、位置及其信号的变化，为临床治疗提供可靠的依据，是目前诊断半月板损伤最好的检查方法。     

膝关节半月板损伤的MRI诊断及临床分析

目的 分析MRI对膝关节半月板损伤诊断的价值.方法 对49例116个半月板损伤的MRI表现与关节镜或手术结果进行对照研究.结果 116个半月板中0级损伤11个,Ⅰ级损伤14个,Ⅱ级损伤50个,Ⅲ级损伤38个(Ⅲa级17个,Ⅲb级11个,Ⅲc级10个),Ⅳ级损伤3个.结论 MRI是膝关节半月板损伤的可靠检查方法.     

MRI与关节镜诊断半月板损伤价值的对照研究

目的 分析MRI诊断半月板损伤的价值,为临床诊断和治疗半月板损伤提供依据.资料与方法 符合纳入标准的168例患者(均为单膝半月板受损),共336个半月板.对膝关节进行术前MRI检查,并于MRI检查后8周内行关节镜术.半月板损伤的MRI分级标准参考Fischer分级法,分为Ⅰ级损伤、Ⅱ级损伤、Ⅲ级损伤;关节镜分级,分为正常、纤毛化和撕裂.结果 与关节镜结果对照,MRI诊断半月板Ⅰ、Ⅱ级损伤的准确性分别为100%、92.9%.诊断半月板撕裂的敏感性、特异性、阳性似然比、准确性、Kappa值分别为93.1%、89.3%、8.7、91.1%、0.82.对半月板撕裂类型诊断总的灵敏性、特异性、阳性似然比、准确性、Kappa值分别为92.0%、79.8%、4.6、84.8%和0.70.结论 MRI不仅能够准确评价半月板损伤程度,而且还能对半月板撕裂进行准确分型.因此,MRI可广泛应用于半月板损伤性疾病的诊断,并进一步指导临床治疗方案的选择.     

半月板损伤的MRI诊断与关节镜对照研究

目的：评价MRI对半月板损伤的诊断价值,为临床诊断和治疗半月板损伤提供可靠的影像学依据。方法：对138例拟行关节镜术的膝关节疼痛患者进行术前MRI检查,并于MRI检查后2周内行关节镜术。结果：符合纳入标准的84例患者中,与关节镜结果对照,MRI诊断半月板Ⅰ级损伤、Ⅱ级损伤的符合率分别为100%和91.1%;诊断半月板撕裂的敏感度、特异度、符合率、Kappa值分别为91.5%、90.7%、91.1%和0.82;对半月板撕裂类型诊断的敏感度、特异度、符合率和Kappa值分别为90.9%、85.7%、88.1%和0.76。结论：与关节镜比较,MRI显示半月板Ⅰ、Ⅱ级损伤时的内部信号改变更敏感。MRI诊断半月板撕裂,与关节镜结果具有极好的一致性,并能准确评价半月板撕裂类型。MRI检查可作为评价半月板损伤的首选方法,对半月板损伤临床治疗方案的选择具有重要指导意义。     

膝关节内侧副韧带损伤的MRI诊断价值

目的:探讨MRI对膝关节内侧副韧带损伤的诊断价值。方法:对59例临床拟诊膝关节内侧副韧带损伤的病例进行了MRI检查,分析其MRI表现,并与30例正常膝关节进行对比研究。结果:59例中,临床确诊为内侧副韧带损伤43例;MRI诊断为内侧副韧带损伤的共有37例,其中Ⅰ级损伤9例,Ⅱ级损伤15例,Ⅲ级损伤13例。MRI诊断膝关节内侧副韧带损伤的敏感度与特异性分别为81.4%和87.5%;对于手术治疗的20例Ⅱ、Ⅲ级的病例,MRI诊断的敏感度达100%。结论:MRI能够准确判断膝关节内侧副韧带有无损伤和损伤的程度及并发症,是较为理想的非创伤性检查方法。     

膝关节半月板及其损伤的MRI研究

目的　研究正常和损伤的膝关节半月板的MRI表现。方法　对经手术、关节镜或临床证实的 2 6例共 3 2个损伤的半月板与 15例正常的膝关节半月板进行回顾性MRI对比观察。结果　显示正常膝关节半月板在T1WI和T2 WI上均呈三角形低信号。 3 2个损伤的半月板 ,其中内侧损伤 15个 ,外侧损伤 11个 ,两侧半月板同时损伤 3例 6个 ,将 3 2个损伤的半月板按Stoller的 4级分法分类 ,其中 0级 0个 ,I级 6个 ,Ⅱ级 12个 ,Ⅲ级 14个。 18例出现并发症 ,其中合并半月板囊肿 6例 ,内侧副韧带损伤 10例 ,外侧副韧带损伤 9例 ,前交叉韧带损伤 7例 ,后交叉韧带损伤 6例 ,骨挫伤 8例 ,骨折 5例 ,关节囊积液 11例 ,膝关节周围软组织内瘀血 6例。结论　MRI能够清晰显示膝关节半月板的解剖结构 ,能准确诊断半月板的损伤并进行分级 ,还能发现多种并发症。     

MR与关节镜诊断半月板损伤的临床价值研究

目的探讨MR与关节镜诊断半月板损伤的临床价值。方法本组72例患者检查86个膝关节,共172例半月板,入院后进行MRI检查评价半月板损伤情况,2周内进行膝关节镜检查,MRI检查结果按Fischer分级标准分I级信号、II级信号、III级信号,关节镜检查结果分正常、退变、撕裂。结果 MRI与关节镜检查诊断半月板损伤结果比较,X~2=1.432,P=0.698,κ=0.694;MRI与关节镜检查诊断半月板撕裂结果比较,X~2=0.529,P=0.629,κ=0.767,MRI诊断半月板撕裂的敏感度86.27%、特异度91.73%、阳性预测值81.48%、阴性预测值94.07%、阳性似然比10.43、阴性似然比0.15、准确度90.12%、假阳性率8.27%、假阴性率13.73%。结论 MRI能够较好的诊断半月板损伤的程度,特别是对半月板撕裂的诊断,MRI的Ⅲ级信号可作为临床选择关节镜检查和手术治疗的一个重要指征。     

膝关节半月板脱位的MRI诊断

目的 探讨膝关节半月板脱位的MRI表现及诊断价值。方法 回顾性分析20例经临床手术证实的膝关节半月板脱位均经MRI检查。主要临床表现为膝关节疼痛。结果 膝关节半月板脱位并半月板撕裂15例；同时膝关节半月板脱位并骨关节炎14例。MRI征象：半月板脱离膝关节面。伴有撕裂可见T2WI稍高信号。T1WI为等信号。结论 膝关节半月板脱位MRI可提供准确的诊断。     

Magnetic resonance imaging of meniscal lesions of the knee

In a prospective study of 25 patients, magnetic resonance imaging (MRI) was employed to detect meniscal tears in the symptomatic knee. All patients underwent arthroscopy and 21 underwent double contrast arthrography. When correlated with these two diagnostic procedures MRI produced no false negative results. There were, however, six false positive MRI findings all of which related to the posterior horn of the medial meniscus. MRI appears to be reliable in detecting meniscal tears but long examination times continue to limit its clinical usefulness.     

半月板损伤部位与临床查体阳性体征的相关性研究

目的:分析半月板损伤部位与半月板损伤查体之间的对应关系,评价各种临床查体方法对半月板损伤诊断的临床价值。方法:对2009年3月~2011年3月通过临床查体及MRI诊断以及关节镜检确诊半月板损伤的114例(123膝)患者进行回顾性分析,研究半月板损伤各种查体方法对于诊断不同部位半月板损伤的敏感度和特异性。结果:各种半月板损伤的查体方法对诊断半月板损伤有着重要的提示作用,并与半月板损伤部位存在明显的相关性。结论:多个相关临床查体相结合可提高半月板损伤诊断的准确率。     

The "floating" meniscus: MRI in knee trauma and implications for surgery

OBJECTIVE: We describe 21 cases involving meniscal injury in which the meniscus appears free-floating on MRI of the knee. In these cases, the meniscus is completely surrounded by fluid. Correlation with surgical reports shows that the "floating" meniscus corresponds to a meniscal avulsion or detachment from the tibial plateau with an associated disruption of the meniscotibial coronary ligaments, which attach the meniscus to the tibia, allowing fluid to encompass the meniscus. A floating meniscus on MRI may represent a new specific finding for an uncommon form of meniscal injury known as meniscal avulsion. CONCLUSION: The presence of a floating meniscus on MRI is a result of significant trauma to the knee leading to meniscal avulsion and is often associated with significant ligamentous injury. Alerting the surgeon to the presence of a meniscal avulsion facilitates appropriate surgical planning with meniscal reattachment to the tibial plateau.     

低场MR在膝外伤中的应用价值

目的探讨低场(0.35 T)MR在膝外伤中的应用及诊断价值。方法对67例X线、4例同时行CT检查均未见明显异常的膝外伤患者行低场MR常规检查,常规自旋回波(SE)T1WI矢状位、快速自旋回波(TSE)T2WI矢状位及T2脂肪抑制序列矢状位及冠状位成像。结果骨挫伤28例,韧带损伤17例,半月板损伤13例,54例患者关节腔内有不同程度的关节腔积液及周围软组织损伤。结论低场MR可诊断膝关节骨质、关节软骨、半月板、韧带、周围软组织的单一及复合损伤,膝外伤后经X线或CT检查无明显异常,临床体检阳性、症状明显者应首选MRI。     

MRI-negative bucket-handle tears of the lateral meniscus in athletes: a case series

Magnetic resonance imaging (MRI) is the most widely used non-invasive test for assessing intra-articular injuries of the knee. It has been suggested that a negative MRI can be useful in avoiding the need for diagnostic arthroscopy in cases where clinical examination is equivocal. However, the sensitivity and specificity of MRI is not 100%, particularly for tears of the lateral meniscus. Furthermore, a false negative MRI scan may result in premature return to play in athletes, resulting in increased risk of further damage to a torn meniscus. To illustrate this issue, we present a case series of eight elite athletes who all presented with mechanical knee symptoms and where MRI scans revealed no significant intra-articular pathology. Five of the athletes were allowed to return to sport on the basis of a negative MRI. All patients were subsequently found to have a bucket-handle tear of their lateral meniscus at arthroscopy. Two independent, experienced musculoskeletal radiologists were asked to review the MRI films without being given any clinical history of the cases. Although injuries to the popliteus tendon were noted in two of the athletes who had sustained a recent acute injury to their knee, no meniscal tears were identified. Thus arthroscopy remains the gold standard for the assessment and management of high-demand patients with a clinical suspicion of meniscal pathology.     

The double ACL sign: an unusual bucket-handle tear of medial meniscus

Several characteristic magnetic resonance imaging (MRI) signs of meniscal bucket-handle tears are well known and widely used. This case report presents a new MRI sign of a meniscal bucket-handle tear. A 17-year-old boy visited our hospital because of the pain in his left knee. Preoperative MRI on sagittal view showed a tear in the anterior horn of the medial meniscus and a displaced fragment of the medial meniscus in front of the original anterior cruciate ligament (ACL), which looks like another ACL. Under arthroscopic examination, the bucket-handle medial meniscus displaced parallel to the ACL was observed. A longitudinal tear was extended from the anterior horn to the posterior horn of medial meniscus. To our knowledge, this new MRI sign of bucket-handle tear, “the double ACL sign”, has not been previously reported. Level of evidence V.     

低磁场强度磁共振成像对膝关节外伤的诊断

目的探讨低磁场强度磁共振成像（MRI）对膝关节外伤的诊断．评价低磁场强度MRI在膝关节外伤诊断中的临床价值。方法回顾性分析30例膝关节外伤（经临床或手术证实）在低场磁共振常规序列MRI的影像表现。结果30例膝关节外伤中21例为复合性损伤（70％）,单纯损伤9例（30％）。结论低磁场强度MRI常规序列扫描可以对膝关节半月板、韧带、骨结构及软骨的损伤作出准确的诊断,在膝关节外伤的诊断中具有很高的临床价值。