中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3078-3080.doi: 10.3969/j.issn.1673-8225.2010.17.010

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

磁共振关节内增强扫描评价膝关节骨质、半月板、韧带和关节软骨损伤的准确性：与常规磁共振扫描比较

葛建忠，励  钢   

  1. 阳泉市第一人民医院骨科，山西省阳泉市  045000
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 作者简介:葛建忠☆，男，1972年生，汉族， 2009年中国中医科学院毕业，博士，副主任医师，主要从事创伤骨科研究。 gejianzhongyq@tom.com

Diagnostic accuracy of magnetic resonance imaging enhancement pattern in knee bone, meniscus, ligaments, and articular cartilage injury: Comparison with routine magnetic resonance imaging scanning

Ge Jian-zhong, Li Gang    

  1. Department of Orthopaedic Surgery, Yangquan First People’s Hospital, Yangquan  045000, Shanxi Province, China
  • Online:2010-04-23 Published:2010-04-23
  • About author:Ge Jian-zhong☆, Doctor, Associate chief physician, Department of Orthopaedic Surgery, Yangquan First People’s Hospital, Yangquan 045000, Shanxi Province, China gejianzhongyq@tom.com

PDF

588

摘要：

背景：常规磁共振检查可较为全面地显示关节内软组织的结构，但由于其成像后对比度欠缺等因素，在诊断关节内病变和损伤时仍存在一定的局限性。为了提高诊断的准确率，磁共振的增强扫描已应用于肝脏、脑等其他部位，但有关膝关节增强扫描的报道较少。
目的：评价磁共振关节内增强扫描对膝关节损伤诊断的临床应用价值。
方法：选择21例膝关节损伤患者(22膝)，采用美国GE公司生产的0.5T Signa  Contour磁共振扫描仪先进行常规磁共振扫描。常规扫描完成后，向关节内注入增强剂，行关节内增强扫描。所有病例均由同一医师进行关节内增强操作，由两名副主任职称以上的医师进行阅片分析和对比。
结果与结论：所有病例在平扫中均发现有不同程度的关节结构损伤，包括骨质、半月板、韧带和关节软骨等。在磁共振增强扫描后进一步证实，其损伤的程度和范围上得到了更清楚的显示。同时，有2例平扫中误诊的半月板损伤，在增强扫描后得到否定；有的损伤部位在平扫中未发现的病变信号，在关节内增强扫描中被发现和证实。说明增强后磁共振扫描膝关节损伤的阳性率高于常规扫描。其中，增强前后半月板损伤诊断准确率差异有显著性意义(P =0.035)。提示，与常规扫描相比，磁共振关节内增强扫描可进一步提高膝关节损伤的诊断率。

关键词: 磁共振, 增强扫描, 膝关节损伤, 诊断, 数字化医学与影像技术

Abstract:

BACKGROUND: Routine magnetic resonance imaging (MRI) scans can comparatively show intra-articular soft tissue structures, but there are still some limitations in the diagnosis of intra-articular lesions and injury due to deficiency in contrast of imaging. Enhanced MRI scan has been applied to the liver, brain and other parts, which effectively improves the diagnostic accuracy, but there are few reports on the enhanced scans of knee.
OBJECTIVE: To evaluate clinical application value of MRI enhancement pattern in diagnosis of knee injury.
METHODS: Totally 21 patients with knee injury (22 knees) were routinely scanned by 0.5T Signa Contour MRI scanner (GE company, USA). Then enhancer was injected into knee joint by the same physician and MRI enhancement pattern was performed in these patients. Film-reading and comparison were completed by two associate chief physicians.
RESULTS AND CONCLUSION: Different levels of joint structural damage, such as bone, meniscus, ligaments, and articular cartilage and so on, were found in all patients by routine MRI scan. The extent and scope of its damage had been more clearly displayed by enhanced MRI scan. Meanwhile, misdiagnosis of meniscal injury by routine MRI scan was confirmed by enhanced MRI scan in 2 patients. Some damaged parts that were not found by routine MRI scan were confirmed by enhanced MRI scan. All these demonstrated that positive rate of knee injury in MRI enhancement pattern was higher than conventional MRI scan. There was significant difference in meniscus injury between two patterns (P = 0.035). MRI enhancement pattern in comparison with conventional MRI can further improve the diagnostic accuracy rate of knee injury.

中图分类号: