MRI诊断病理性髌内侧滑膜皱襞

目的 探讨MRI对病理性髌内侧滑膜皱襞（MPP）的诊断价值。方法 回顾性分析经关节镜证实的21例病理性MPP患者和22例MPP正常者的MRI，观察矢状位质子密度-T2W （PD-T2W）、矢状位脂肪抑制PD-T2W （PD-T2WI-FS）和轴位T2^*-GRE序列MPP表现。以关节镜结果为标准，计算各序列诊断病理性MPP的敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV），并分析其与关节镜诊断的一致性。结果 矢状位PD-T2W序列诊断病理性MPP的敏感度为100%（21/21），特异度为63.63%（14/22），PPV为72.41%（21/29），NPV为100%（14/14）；矢状位脂肪抑制PD-T2W （PD-T2WI-FS）诊断病理性MPP的敏感度为85.71%（18/21），特异度为68.19%（15/22），PPV为72.00%（18/25），NPV为83.33%（15/18）；其诊断结果与关节镜结果的一致性好（Kappa=0.81、0.77）。轴位T2^*-GRE序列与关节镜诊断的一致性较好（Kappa=0.72）。结论 MRI对诊断病理性MPP有重要价值，选择适当检查序列是显示MPP的关键。

MRI diagnosis of pathologic mediopatellar plicae

Objective To observe the value of MRI in diagnosis of pathologic mediopatellar plicae (MPP) of the knee. Methods MRI data of 21 patients with pathologic MPP and 22 controls with normal MPP confirmed by arthroscopy were analyzed retrospectively. Three MR sequences, including sagittal proton density-T2W (PD-T2W), sagittal fat suppression PD-T2W (PD-TSE-FS) and axial T2^*-GRE were performed. Taking arthroscopic findings as the standards, the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) of MRI were calculated, and the consistency between MRI sequences and arthroscopic findings in diagnosis of pathologic MPP was evaluated. Results The sensitivity, specificity, PPV and NPV of PD-T2WI in diagnosis of pathologic MPP was 100% (21/21), 63.63% (14/22), 72.41% (21/29) and 100% (14/14), respectively; the sensitivity, specificity, PPV and NPV of PD-T2WI-FS in diagnosis of pathologic MPP was 85.71%(18/21),68.19%(15/22), 72.00%(18/25)and 83.33%(15/18),and the consistency with arthroscopic findings was good (Kappa=0.81, 0.77) while the consistency of T2^*-GRE with arthroscopic findings were relatively good (Kappa=0.72). Conclusion MRI has great value in diagnosis of pathologic MPP, and choosing the appropriate sequence is the key point.