892例男性患者MRI髋关节检查中关节外病变的发现率及其漏诊的分析

The Detection Rate and Missed Diagnostic Rate of Incidental Extra-Hip Findings in 892 Male Patients at Hip Joint MRI

目的探讨男性患者髋关节MRI检查中关节外意外发现(IEHFs)的发现率及漏诊率,评估其临床意义。方法回顾性分析2014年9月至2018年9月892例男性患者髋关节MRI检查资料,发现IEHFs,并根据修订后的CT结肠成像报告数据系统(C-RADS)将其分为E1、E2、E3、E4四类。将结构化读片的结果与初始的MRI报告结果进行比较,计算IEHFs的漏诊率。结果在892例男性患者中,发现502例患者存在691个IEHFs,其中E2类296个(42.8%),E3类277个(40.1%),E4类118个(17.1%)。40岁以下及40~60岁之间男性患者IEHFs均以E2为主,而60岁以上则以E3类为主。不同年龄组间IEHFs构成差异有统计学意义(χ2=87.642,P<0.001)。IEHFs漏诊率为87.4%。结论在男性患者髋关节MRI检查中,IEHFs普遍存在。使用结构化读片方法阅读MRI图像可以提高IEHFs的发现率;根据修订后的C-RADS对IEHFs进行分级报告,可以降低漏诊率。

Objective To explore the frequency,missed diagnostic rate,and clinical significance of incidental extra-hip findings(IEHFs)at male hip joint magnetic resonance imaging(MRI).Methods The data of 892 male patients who underwent MRI examination of hip joint from September 2014 to September 2018 were retrospectively analyzed.According to the revised CT Colonography Reporting and Data System(C-RADS),IEHFs is divided into four categories:E1 is anatomical variation;E2 has no clinical significance;E3 has little clinical significance;E4 has important clinical significance.The missed diagnostic rate was determined by comparing the results of the structured approach with the initial MRI reports.Results Among 892 male patients,691 IEHFs were found in 502 patients,including 296 E2 patients(42.8%),277 E3 patients(40.1%)and 118 E4 patients(17.1%).The IEHFs of patients under 60 years old were mainly E2,while those over 60 years old were mainly E3.There was significant difference in IEHFs composition among different age groups(χ2=87.642,P<0.001).The missed diagnostic rate of IEHFs was 87.4%.Conclusion IEHFs are common in male patients who ahd hip MRI examination.Using structured reading method to read MRI images according to the revised C-RADS classification report can increase the diagnosis rate of IEHFs and can reduce the missed diagnosis rate.