膝关节半月板损伤磁共振成像诊断与关节镜检查对比研究

目的探讨MRI在膝关节半月板损伤诊断中的应用价值。方法回顾性分析70例同时接受MRI和关节镜检查的膝关节损伤患者的病历资料。共涉及86个膝关节，左膝27例，右膝40例，双膝同时发病19例。所有患者均有外伤史，主要表现为膝关节疼痛、肿胀、功能受限及绞锁。结果按照Stoller等半月板损伤MRI分级标准，0级8膝，Ⅰ级2膝，Ⅱ级16膝，Ⅲ级60膝。经关节镜检查，MRI检查诊断为0级的8膝膝关节中有2膝为外侧半月板边缘撕裂；MRI检查诊断为Ⅱ级和Ⅲ级半月板损伤的膝关节中分别有1膝经关节检查证实其异常高信号为滑膜增生而非半月板损伤。经Kappa检验，MRI检查和关节镜诊断半月板损伤结果的一致性较好（Kappa=0．724，P=0．000）。MRI诊断半月板损伤的敏感度为97．44％，特异度为75％，准确率为95．35％。结论MRI检查和关节镜诊断半月板损伤结果的一致性良好，敏感度和准确率高，安全无创，应作为临床诊断半月板损伤的首选方法。

Comparative study of magnetic resonance imaging diagnostic arthroscopy knee meniscus.

Objective To investigate the value of MRI in the diagnosis of knee meniscus injury. Methods The medical records, MRI and arthroscopy in 70 patients with knee injuries were analyzed restrospectively. The study included a total of 86 knee, left knee in 27 cases, right knee in 40 cases, bilateral knees in 19 cases. All patients had a history of trauma, mainly limited to knee pain, swelling, and function and twist. Results According to Stoller meniscus injury of MRI grading standards, this study included 8 knees with 0 grade, 2 knees with I grade, 16 knees with II grade, 60 knees with III grade. By arthroscopy, MRI demonstrated the lateral meniscus tear in 8 patient with 0 grade. MRI demonstrated abnormal high signal synovial hyperplasia rather than meniscus injury in II and m grade meniscus injury knee. The Kappa test the consistency of MRI inspection and arthmscopic diagnosis of meniscus injury results （ Kappa = 0. 724, P = 0. 000）. The sensitivity of MRI diagnosis in meniscus injury of 97.44% and a specificity of 75%, the accuracy rate of 95.35%. Conclusion MRI inspection and arthroscopic diagnosis of meniscus injury had good consistency, high sensitivity and accuracy, safe, non - invasive. MRI inspection should be used as the preferred method for clinical diagnosis of meniscus injury.