磁共振成像在膝关节软骨损伤诊断中的价值评价

目的：评价磁共振成像各序列在膝关节软骨损伤诊断中的价值,为临床医生诊断和治疗膝关节软骨损伤提供可靠的依据。方法：回顾性分析106例膝关节病变患者关节镜术前磁共振成像的检查结果与关节镜检查结果。将每个膝关节的软骨面分成6个部分：髌骨、股骨滑车、股骨内髁面、股骨外髁面、胫骨平台内侧面和胫骨平台外侧面。根据关节镜检图片和手术记录对各个观察面的软骨损伤进行分级,并以此为标准,评价术前MRI常规快速自旋回波T1加权像、快速自旋回波T2加权像及三维脂肪抑制扰相梯度回波3个序列对关节软骨损伤的诊断和病变分级报告。采用诊断试验的一致性检验对MRI各序列在膝关节软骨损伤诊断中的价值进行评价。结果：在与关节镜诊断的一致性上,快速自旋回波T1加权像序列和快速自旋回波T2加权像序列一致性中等（Kappa=0.534,P=0.000;Kappa=0.581,P=0.000）;三维脂肪抑制扰相梯度回波序列的一致性非常好（Kappa=0.850,P=0.000）;在敏感度和准确度方面,三维脂肪抑制扰相梯度回波（96.5%,94.1%）〉快速自旋回波T2加权像（62.8%,73.6%）〉快速自旋回波T1加权像（51.6%,69.2%）;三者的特异度相差较小。结论：磁共振成像三维脂肪抑制扰相梯度回波序列诊断关节软骨损伤病变,具有较高的准确性和敏感度,与关节镜诊断具有良好的一致性,是诊断关节软骨损伤的较好方法。

Evaluation on the value of magnetic resonance imaging in the diagnosis of cartilage lesions in knee joint

Objective:To make an evaluation on the value of every sequence of magnetic resonance imaging(MRI)in the diagnosis of cartilage lesions in knee joint,and to provide the reliable basis for the clinicians in the diagnosis and treatment of knee cartilage lesions.Methods:MRI findings before arthroscopy and arthroscopic findings of 106 patients with knee lesions were analyzed retrospectively.Every chondral surface of knee joint was divided into the following 6 parts as patellar surface,surface of femoral trochlea...