摘要
目的探讨四肢关节MRI在膝关节交叉韧带损伤中的扫描成像方法,分析MRI诊断的敏感性、特异性和准确性,从而评价四肢关节MRI在膝关节交叉韧带损伤中的临床应用价值。方法对临床疑有膝关节交叉韧带损伤的患者进行关节MRI扫描并追踪,随机选择扫描后一周内经临床关节镜检查或治疗的患者50例作为研究对象,双侧膝关节交叉韧带损伤占16%(8例),共58个病变膝关节。将其MRI征象及MRI诊断结果与关节镜术中所见及术后诊断进行比较,对其MRI征象与诊断的相关性进行分析,评价关节MRI诊断的敏感性、特异性和准确性。结果 50例患者中,其中前交叉韧带损伤占87%(51条),关节MRI定性诊断敏感性为96.2%,特异性为100%,符合率为0.966。后交叉韧带损伤占17%(10条),关节MRI定性诊断敏感性为90.9%,特异性为95.7%,诊断符合率为0.948。MRI直接征象具有较高的敏感性、特异性和阳性预测值,是诊断的主要依据,MRI间接征象特异性虽较高,但敏感性较低,当缺少直接征象难以做出明确诊断时,其间接征象具有重要的参考价值。结论四肢关节MRI对膝关节交叉韧带的损伤具有较高的诊断准确率,可为临床提供准确的影像学依据,是交叉韧带损伤最为重要的影像学检查手段。
Objective To discuss the imaging methods of joint MRI when curing the cruciate ligament injury of knee joint and analyze the sensitivity,specificity and accuracy of MRI diagnosis.Then evaluate the MRI′s clinical applications in the cruciate ligament injury of knee joint.Methods With MRI,scan and track the patients who were clinically suspected knee ligament damage,randomly select 50 cases who were clinical arthroscopy or treatment within one week after scanning as research subjects.Compared the MRI signs and diagnosis with the arthroscopic intraoperative and postoperative diagnosis,analyzed the correlation between MRI signs and diagnosis,and evaluated the sensitivity,specificity and accuracy of MRI diagnosis.Results Among 50 patients,8 patients were bilateral knee cruciate ligament injury,a total of 58 lesions of the knee,including 51 anterior cruciate ligament injuries.MRI diagnosis sensitivity was 96.2%,specificity was 100%,accuracy was 0.966.10 posterior cruciate ligament injuries,MRI diagnosis sensitivity was 90.9%,specificity was 95.7%,accuracy was 0.948.The direct signs of MRI had a high sensitivity,specificity and positive predictive value,which is the main basis for the diagnosis,though the specificity of the indirect signs of MRI was high,the sensitivity was low.So when lacking of direct signs,a clear diagnosis could not have available,MRI indirect signs could have great reference value.Conclusions MRI has a high diagnostic accuracy on the cruciate ligament injury of knee joint and provide accurate images for clinical diagnosis and treatment,it is the most important imaging method of cruciate ligament injury.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第14期4105-4115,共11页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家自然科学基金(30660072)
内蒙古自然科学基金(2009MS1103)
关键词
膝交叉韧带损伤
磁共振成像
病例对照研究
Cruciate ligament injury of the knee joint
Magnetic resonance imaging
Case-control study
