半月板损伤几种诊断方法的评价——物理诊断、关节造影、B超、MRI与关节镜诊断比较

作者对65例怀疑有半月板损伤的膝关节镜诊断结果进行分析,并分别报告了物理诊断、关节造影、B超和MRI的准确率,从而对每种检查方法进行评价.65例中20例分别进行了物理诊断、关节造影、B超、和MRI四项检查.对内侧半月板其准确率分别为60%、85%、50%、80%.敏感性分别为42.9%、57.1%、14.3%、71.4%.特异性为62.9%、100%、69.2%、84.6%.对外侧半月板其准确率分别为65%、75%、65%、90%.敏感性为81.8%、63.6%、63.6%、81.8%.特异性为44.4%、88.9%、66.7%、100%.作者认为对于半月板损伤单凭物理检查或B超难以作出正确的诊断,关节造影对内侧半月板损伤的诊断有较高的参考价值.MRI的准确率、敏感性与特异性高于其他检查,几乎可以代替关节造影、B超及诊断性关节镜检查.

Evaluation of Kinds of Method in the Diagnosis of Meniscal Lesion-A Comparison of Physical Examination, Arthrography.B-ultrasound and MRI with the Findings of Arthroscopy

Sixty - five arthroscopic results of knee which were suspected of meniscal lesions preoperatively were analysed in this paper. The accuracy rate of physical examination,arthrogarphy. B - ultrasound and MRI were reported respectively,and every method was evaluated in different respects. Of 65 cases,20 were examined by physical examination , arthrography,B-ultrasound,MRI and arthroscopy. For medial meniscal lesions the rate of accuracy is 60%,85%,50%,80%,respectively, the sensitivity is 42. 9%,57. 1%,14. 3%,71. 4% sand the specificity is62. 9% ,100%, 69. 2%,84. 6%,For lateral meniscal lesions the rate of accuracy is 65% ,75%,65% ,90%, respectively;the sensitivity is 81. 8%,63. 6%,63. 6%,81. 8%;the specificity is 44. 4%,88. 9%,66. 7%,100%. Based on this paper it was concluded it may be difficult to make a correct diagnosis for meniscal lesions only by way of physical examination or B-ultrasound . Arthrography provides reliable information for medial meniscal lesions. The accuracy, sensitivity and specficity of MRI is higher than other methods. It is a valuable method and can replace arthrography and B-ultrasound and diagnostic arthroscopy.