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。

MRI Diagnosis of Meniscal Injuries of the Knee:Correlated with Arthroscopy

Objective：To evaluate the efficacy of MRI in the diagnosis of meniscal injuries of knee,in order to provide reliable imaging evidence for the clinical diagnosis and treatment. Methods： 1 38 consecutive patients with persistent symptoms of knee pain and were scheduled for arthroscopy in two weeks underwent MR examination before operation. Results： 84 patients were included in this study. Correlated with arthroscopy findings,the accuracy of MRI diagnosis of grade Ⅰ and grade Ⅱmeniscal injury were 100 % and 91.1% respectively. The sensitivity, specificity,accuracy and Kappa value of MRI in the diagnosis of meniscal tear were 91.5 %, 90.7 %, 91.1 % and 0.82 respectively. The sensitivity, specificity, accuracy and Kappa value of MRI in the typing of meniscal tears were 90. 9%, 85. 7%, 88. 1 % and 0.76 respectively. Conclusion： Correlated with the arthroseopy findings, MRI was more sensitive than arthroscopy in assessing the internal structure of grade Ⅰ and grade Ⅱ meniscal injury. MRI was in good accordance with arthroseopy in detecting meniscal tears,the types of meniscal tearsl could be accurately evaluated. MRI can be served as the first choice imaging examination for the diagnosis of meniscal injury of the knee joint,which is significant in treatment planning.