半月板损伤及撕裂的MRI与关节镜或手术对照研究

目的评价不同观察者对膝关节半月板损伤MRI诊断一致性及撕裂形态学MRI诊断分级的准确性。方法由两位有经验的影像科医生回顾性对82例82个疑有半月板损伤的MRI图像,所得两次诊断结果进行Kappa统计量分析。本研究中用关节镜或手术结果作为诊断参考标准,确诊撕裂的内侧半月板有29例,外侧半月板有40例,分别分析内外侧半月板经参考标准确诊的撕裂的两次诊断的诊断价值。结果对内侧半月板Kappa值为0.71,对外侧半月板Kappa值为0.65,两次诊断均有好的诊断一致性。对内侧半月板可修复撕裂两次诊断的灵敏性、特异性、准确性分别为95%、38%、79%;100%、38%、83%。对外侧半月板可修复撕裂两次诊断的灵敏性、特异性、准确性分别为93%、65%、75%;93%、77%、93%。结论MRI两次诊断对内外侧半月板诊断一致性良好,对内外侧半月板可修复撕裂准确性、灵敏度较高,对外侧半月板可修复撕裂特异度较高。

The Correlation of MRI Study and Arthroscope or Surgery on Meniscal Injury and Tear of Knee Trauma

Objective:To evaluate the diagnostic agreement of different observers in MRI of meniscal injuries and the accuracy for the configuration categorizing in MRI diagnosis of meniscal tears.Methods:82 cases of MR imaging of menisci were retrospectively analysed by two experienced radiologists.The first results were compared with the second results of each patient with the Kappa statistic analyses.MR imaging diagnosis reports were compared with arthroscopy or surgery results which served as the standard of diagnosis reference.According to the reference the diagnosis of 29 medial and 40 lateral meniscal tears were analysed.Results:For medial and lateral menisci,the first and second diagnostic results had excellent agreement and the Kappa value was 0.71 and 0.65 respectively.For medial menisci,sensitivity,specificity and accuracy of the first and second diagnostic results of the reparable tears were respectively 95%,38% and 83%;100%,38% and 83%.For medial and lateral menisci,sensitivity,specificity and accuracy of the first and second diagnostic results of the reparable tears were respectively 93%,65% and 75%;93%,77% and 93%.Conclusion:For lateral menisci,the results between them had good agreement;MRI diagnosis for the reparable tears was of high accuracy and sensitivity.MRI diagnosis for the unreparable tears was also of high specificity.