MRI诊断青少年运动性膝关节软骨损伤的价值探究

Value of MRI in the diagnosis of sports related cartilage injury of knee joint in adolescents

目的 探究MRI对青少年运动性膝关节软骨损伤的诊断价值。方法 连续收集2020年1月-2021年6月郑州市第七人民医院收治的52例青少年运动性膝关节软骨损伤患者,以关节镜为金标准,对比分析MRI诊断软骨损伤的敏感度、特异度和准确度。应用McNemar检验和Kappa检验评价两者诊断的差异性和一致性。结果 52例患者,共计312处软骨,关节镜诊断Ⅰ级损伤22处,Ⅱ级损伤25处,Ⅲ级损伤18处,Ⅳ级损伤29处,Ⅴ级损伤20处;MRI诊断Ⅰ级损伤23处,Ⅱ级损伤25处,Ⅲ级损伤21处,Ⅳ级损伤29处,Ⅴ级损伤20处。McNemar检验MRI对比关节镜结果的差别无统计学意义(P=0.523),Kappa检验MRI与关节镜结果的一致性较好(Kappa=0.849)。MRI诊断软骨损伤的敏感度为92.11%,特异度为93.43%,准确度为92.95%。结论 MRI能够准确评估青少年膝关节软骨损伤的部位、分级,为临床后续治疗提供可靠依据,值得广泛应用。

Objective To investigate the value of magnetic resonance imaging(MRI)in the diagnosis of sporting related cartilage injury of the knee joint in adolescents.Methods 52 adolescents with sporting related knee cartilage injury treated in the Seventh People's Hospital of Zhengzhou from January 2020 to June 2021 were collected continuously.Taking arthroscopy as the gold standard,the sensitivity,specificity and accuracy of MRI in the diagnosis of cartilage injury were compared.The difference and consistency of two kinds of diagnosis methodswere evaluated by McNemar test and Kappa test.Results A total amount of cartilage was 312 pieces.There were 22 cases in gradeⅠinjuries,25 cases ingradeⅡinjuries,18 cases in gradeⅢinjuries,29 cases in grade Ⅳ injuries,and 20 casesingradeⅤinjuries diagnosed by arthroscopy;while MRI diagnosed results showed that 23 caseswere in gradeⅠinjuries,25 caseswerein GradeⅡinjuries,21 cases were in gradeⅢinjuries,29 cases ingradeⅣinjuries,and 20cases in gradeⅤinjuries.There was no significant difference between MRI and arthroscopy in McNemar's test(P=0.523).The consistency between MRI and arthroscopy in Kappa's test was better(Kappa=0.849).The sensitivity,specificity,accuracy of MRI in the diagnosis of cartilage injury was 92.11%,93.43%,92.95%,respectively.Conclusion MRI can accurately evaluate the location and grade of knee cartilage injury in adolescents,provide more reliable evidence for clinical follow-up treatment and be worth applying widely.