MRI在膝关节骨关节炎诊断中的应用评价

这项研究的目的是ＭＲＩ与常规最基本的Ｘ线平片比较，来评价ＭＲＩ在膝关节ＯＡ诊断中的应用价值，并设立一套符合病理进程、反映临床严重程度的分期，使膝关节ＯＡ诊断规范化。２８例住院治疗的膝关节ＯＡ患者，在术前进行膝ＭＲＩ、站立位Ｘ线片检查，为临床评定分期；利用关节置换或钻孔减压术中取出的骨为标本，做光镜观察并与ＭＲＩ、Ｘ线片一一对照。（１）ＭＲＩ与病理对照ＭＲＩ的符合率为８１．３％，灵敏度为８５．２％，特异度为７６．０％。均高于Ｘ线片的符合率（５２．８％），灵敏度（５１．６％），特异度（６０．０％）。（２）ＭＲＩ能反映膝ＯＡ的最早的病理改变是纤绒样变（ｆｉｂｒｉｌａｔｉｏｎ）。（３）依照病理演进过程将膝ＯＡ的ＭＲＩ表现分为四期，统计分析证实与临床分期有良好对应关系。（４）膝关节ＯＡ常伴有半月板退变，本组占７１．２８％。

The Evaluation of MRI for the Diagnosis of OA of the Knee Joint

The purpose of this study was to use plain radiographs and MR Imaging to compare the relative value of these methods in disease evaluation, to establish a set of criteria of MRI classification which accord to pathological changes to reflect clinical severity, and to make diagnoseabout osteoarthritis of the knee to establish the standard. Twenty eight patient with OA of the knee were evaluated by radiography, MRI and clinical grade before operation. The specimen that came from the knee replacement and drilling decompression were made the pathological section. The each section contrasted with MRI and radiography . The results showed: (1)MRI contrasted with the pathological section, the rate of accuracy was 81.3%, the sensitivity was 85.2%, the specificity was 76.0%. X ray contrasted with the pathological section, the rate of accuracy was 52.8%, the sensitivity was 51.6%, the specificity was 60.0%. (2) The earliest pathological change that MRI can reflect was fibrillation. (3) Base our finding we classified appearance of MRI into four grades. The statistical inference verify that MRI grades correlate with clinical grades. (4) The osteoarthritis of the knee often follow the degeneration of meniscus.