中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3081-3084.doi: 10.3969/j.issn.1673-8225.2010.17.011

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

MRI检查对半月板损伤类型的评价

龙  浩，董伟强，白  波，郭志勇，尹知训   

  1. 广州医学院第一附属医院骨科，广东省广州市 510120
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 通讯作者: 董伟强，硕士，骨外科主任医师，广州医学院第一附属医院骨科，广东省广州市 510120 dwqdoctor@163.com
  • 作者简介:龙 浩，男，1973年生，广东省吴川市人，汉族， 1997年广州医学院毕业，骨外科副主任医师，主要从事创伤骨科方面的研究。 Longhao182@126.com

Evaluation of meniscus injury types using magnetic resonance imaging

Long Hao, Dong Wei-qiang, Bai Bo, Guo Zhi-yong, Yin Zhi-xun   

  1. Department of Orthopedic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou   510120, Guangdong Province, China
  • Online:2010-04-23 Published:2010-04-23
  • Contact: Dong Wei-qiang, Master, Chief Physician, Department of Orthopedic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China dwqdoctor@163.com
  • About author:Long Hao, Associate chief physician, Department of Orthopedic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China Longhao182@126.com

PDF

801

被引次数

22

摘要：

背景：MRI诊断半月板损伤的准确性可达80%~100%，但在临床上也存在一定程度的假阳性和假阴性。
目的：通过半月板损伤的MRI检查及关节镜，探讨半月板不同损伤类型的不同MRI表现。
方法：选择2003-01/2008-12因膝关节损伤行术前MRI检查患者212例，由放射科及骨科的高级职称医师共同阅片，预测半月板损伤及其损伤形态。由主任医师行关节镜探查，以术中所发现的半月板损伤作为诊断的金标准，对比两者准确性，统计MRI诊断的准确性。
结果与结论：212例患者(230个膝关节)中MRI检查可疑半月板损伤215膝，由关节镜探查术证实半月板损伤213膝，MRI检查对半月板损伤诊断的敏感度为93.5%，特异度为64.7%，准确度为93.0%。发现MRI诊断半月板桶柄样损伤的敏感度较高，对半月板轻微撕裂伤易出现漏诊，对外侧半月板损伤诊断的假阳性较多。临床实际操作时，若半月板损伤表现为Ⅲ级信号、损伤后移位或有关节囊分离等情况，则提示半月板不稳定，应给予关节镜探查或进一步的手术治疗以免遗漏。

关键词: 半月板, 磁共振成像, 诊断, 膝关节, 数字化骨科

Abstract:

BACKGROUND: Magnetic resonance imaging (MRI) is considered safe for diagnosis of meniscus injury, having accuracy as high as 80% to 100%. However, it is found that there are some false positive and false negative in the clinic.
OBJECTIVE: Through assessment of menisci injuries of the knee using magnetic resonance imaging and arthroscopy, to investigate MRI manifestation in different types of meniscal injuries.
METHODS: A study from January 2003 to December 2008 was performed in 212 patients with knee injury undergoing preoperative MRI. Radiograph was read by physicians who had a senior professional title from radiology and orthopaedics departments, and meniscus damage and damage morphology were predicted. Arthroscopy was conducted by chief physician. Meniscus damage during surgery was considered as gold standards. The accuracy of them was compared. The statistics of accuracy of MRI diagnosis was gathered.
RESULTS AND CONCLUSION: Totally 212 patients and 230 knees were included, and a total of 215 knees of meniscus injury were described by MRI diagnosis and 213 knees of meniscus injury were proven by arthroscopy. The sensitivity, specificity and accuracy of MRI diagnosis of meniscus injury respectively were 93.5%, 64.7%, 93.0%. It is found that the sensitivity of MRI diagnosis of bucket-handle damage is high. MRI is easy to miss diagnosis in a light meniscus posterior horn tear, and resuts are more false positive in lateral meniscus injury. It needs arthroscope operation or further surgery in some condition such as grade Ⅲ type injury, meniscus displacement after injury and articular capsule separation, which indicates instable meniscus.

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