摘要
背景:MRI以其无创及对组织的高分辨率,对损伤的高敏感性和特异性等特点已成为继膝关节疾病关节镜检查的又一重要手段。目的:通过磁共振成像和关节镜检查对膝关节半月板损伤结果进行对比,探讨膝关节半月板损伤诊断的有效评价方法。方法:回顾分析膝关节半月板损伤206例患者的临床资料,对患膝均进行MRI检查及关节镜检查。以关节镜检查结果为金标准,计算出MRI诊断半月板损伤的灵敏度、特异度、符合率。采用χ2检验分析来评价MRI与关节镜检查半月板损伤有无差异。采用Kappa值来检验MRI与关节镜诊断半月板损伤的一致性。结果与结论:MRI对半月板0级、Ⅰ级损伤与关节镜诊断的符合率为97%,对半月板Ⅱ级损伤诊断的符合率为91.1%,两者差异无显著意义(P>0.05)。MRI对半月板Ⅲ级损伤诊断的灵敏度(Sen)92.9%,特异度(Spe)94.4%,符合率为93.7%,Youden指数为87.3%,经一致性检验,两者具高度一致性(Kappa值为0.874,统计量χ2=38.182,P=0.000)。结果提示,MRI是半月板损伤很有价值的无创性诊断方法,对于MRI表现为半月板损Ⅰ、Ⅱ级损伤的患者,应谨慎行关节镜检查;然而对于MRI表现为Ⅲ级信号的患者应尽早行关节镜检查,关节镜观察更直观,能对半月板的损伤作出准确的判断,降低漏诊率。
BACKGROUND：MRI characterized as non-invasion, high resolution, high sensitivity and specificity to injury has become another important means for diagnosis of knee joint disease folowing the arthroscopy. OBJECTIVE： To explore the effective evaluation on the knee meniscus injury diagnosis, by comparing the results of MRI and arthroscopy of the knee meniscus. METHODS： Clinical data of 206 patients with meniscus injury were retrospectively analyzed. Every case was subjected to MRI and the arthroscopy. The findings of arthroscopy were considered as the golden standard. Then, the sensitivity, specificity and coincidence rate of MRI in the diagnosis of meniscus injury were calculated. The chi-square analysis was used to evaluate the MRI and arthroscopy in the diagnosis of meniscus injury. The Kappa values were used to test the consistency of MRI with arthroscopy in the diagnosis of meniscus injury. RESULTS AND CONCLUSION：For levels 0 and I meniscus injury, the coincidence rate of MRI was 97%; for level II meniscus injury, the coincidence rate of MRI was 91.1%, and there was no significant difference （P 〉 0.05）. For level III meniscus injury, the sensitivity, specificity, concordance rate and Youden index of MRI were 92.9%,＆amp;nbsp;94.4%, 93.7% and 87.3%, respectively. By the consistency checking, the value of Kappa was 0.874 and χ2 so there was a high consistency checking between the data of MRI and arthroscopy （P=0.000）. MRI is a noninvasive diagnostic method for meniscus injury. For patients with levels I and II meniscus injury on MRI, arthroscopy should be cautiously adopted; however, for patients with level III meniscus injury on MRI, arthroscopy should be done as early as possible. Arthroscopic observation is more intuitive that enables to make accurate judgments of meniscus injury to reduce the rate of misdiagnosis.
出处
《中国组织工程研究》
CAS
CSCD
2014年第46期7406-7411,共6页
Chinese Journal of Tissue Engineering Research
基金
新疆乌鲁木齐市应用技术研究与开发资金(Y111310026)~~
