后踝撞击综合征MRI和CT诊断价值分析

【摘要】目的:研究电子计算机断层扫描（CT）和磁共振成像（MRI）对后踝撞击综合征的诊断价值。方法:回顾性分析疑似后踝撞击综合征患者80例，均实施关节镜下手术治疗，且在术前进行CT和MRI检查。观察CT和MRI对后踝撞击综合征诊断情况，并对两种诊断方式一致性及诊断效能进行分析。结果:80例患者中经关节镜确诊后踝撞击综合征诊患者70例（87.50%），其中CT诊断后踝撞击综合征患者51例（63.75%），MRI诊断后踝撞击综合征患者65例（81.25%），两种方式诊断率差异有统计学意义（P<0.05）。两组诊断方式特异度和阳性预测值均为100%，其中MRI灵敏度、准确性、阴性预测值均优于CT（P<0.05）。CT诊断结果与关节镜手术结果具有一致性（Kappa>0.4），MRI诊断结果与关节镜手术结果一致性较好（Kappa>0.7）。结论:后踝撞击综合征术前辅助检查使用MRI诊断准确率、诊断效能及一致性均优于CT，临床应用价值较高。

Diagnostic values of MRI and CT in posterior ankle impingement syndrome

Abstract: Objective To investigate the values of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of posterior ankle impingement syndrome. Methods Eighty cases of suspected posterior ankle impingement syndrome were analyzed retrospectively. All patients underwent arthroscopic surgery, and examined with CT and MRI before surgery. The diagnostic performances of CT and MRI in posterior ankle impingement syndrome were observed. The consistency and diagnostic efficiency of the two diagnostic methods were also analyzed. Results Seventy (87.50%) of the 80 patients were diagnosed with posterior ankle impingement syndrome by arthroscopy. There were 51 (63.75%) cases diagnosed with posterior ankle impingement syndrome by CT, and 65 (81.25%) cases by MRI. The differences in diagnosis rate between CT and MRI were statistically significant (P<0.05). The specificity and positive predictive value of CT and MRI were all 100%, but the sensitivity, accuracy and negative predictive value of MRI were higher than those of CT (P<0.05). The CT diagnosis was consistent with the diagnosis of arthroscopic surgery (Kappa>0.4), and the consistency between MRI diagnosis and the diagnosis of arthroscopic surgery was relatively better (Kappa>0.7). Conclusion Compared with CT, MRI has a higher diagnostic accuracy, diagnostic efficiency and consistency in the auxiliary examination before surgery for posterior ankle impingement syndrome, with higher clinical application value.