采用流行病诊断学方法探讨MRI在膝关节交叉韧带损伤中的应用

摘要:目的　采用流行病诊断学方法探讨MRI 在膝关节韧带损伤诊断中的应用价值。方法　收集56例临床疑有膝关节交叉韧带损伤患者的MRI影像资料，并与关节镜所见的相关性进行回顾性研究。结果　前交叉韧带损伤中，位于股骨髁附着点、韧带中部和胫骨附着点的损伤分别有8例、40例、8例；后交叉韧带损伤中，位于股骨髁附着点、韧带中部和胫骨附着点的损伤分别有3例、5例、4例。MRI检查结果与关节镜比较，MR诊断前交叉韧带损伤的灵敏度为96.42%，特异度为100.00%。阳性预测值为100.00%。MR诊断后交叉韧带损伤的灵敏度为94.12%，特异度为96.08%。阳性预测值为88.89%。结论　MRI对诊断交叉韧带损伤的灵敏度、特异度和阳性预测值均较高，是膝关节交叉韧带损伤临床诊断的一种无创性首选影像学方法。

MRI in the diagnosis of knee cruciate ligament damage

Abstract: Objective This study was to investigate of the application potential of MRI in the knee ligament damage detection. Methods MRI image data of 56 patients with suspected knee cruciate ligament injury were collected, and compared with arthroscopy for the retrospective study. Results Among the cases of anterior cruciate ligament injury, there were 8 cases of ligament damage located at the femoral condyle attachment points, 40 cases of injury in the middle of femoral condyle, and 8 cases at the tibial attachment points. Among the cases of posteriorcruciate ligament injury, there were 3 cases with ligament damage located at the femoral condyle attachment points, 5 cases in the middle of the femoral condyle and 4 cases at tibial attachment points. Compared with arthroscopy, the sensitivity of MRI diagnosis of anterior cruciate ligament damage was 96.42%, and the positive prediction rate was 100%. In the diagnosis of cruciate ligament damage, the sensitivity of MRI was 94.12%, the specificity was 96.08%, and the positive prediction rate was 88.89%. Conclusion The sensitivity, specificity and positive prediction rate of MRI are all high in the diagnosis of cruciate ligament injury. It is therefore recommended primarily here as a noninvasive imaging method for the clinical diagnosis of knee cruciate ligament injury.