弥散法MR膝关节造影诊断半月板撕裂临床应用价值的探讨

The diagnostic value of indirect magnetic resonance arthrography in detecting meniscal tears of the knees

目的探讨弥散法MR膝关节造影诊断半月板撕裂的临床应用价值。方法对56例临床怀疑半月板撕裂的患者,首先采用膝关节常规MR平扫,然后进行弥散法MR膝关节造影检查,再经关节镜或手术证实,将常规平扫结果和弥散法关节造影诊断结果与关节镜或手术结果对照,对比2种方法在显示半月板撕裂图像敏感性和诊断符合率方面的差异。结果弥散法MR膝关节造影使半月板撕裂处信号强度明显高于常规平扫,同时检查的诊断符合率从52.20%提高到78.67%,对2种方法确诊率进行χ2检验的统计学分析,2组之间差异有统计学意义(χ2=21.066,P<0.01)。结论弥散法膝关节造影从对半月板撕裂图像敏感性到诊断符合率均优于常规MR平扫。

Objective To explore the diagnostic value of indirect magnetic resonance （MR） arthrography in detecting meniscus tears of the knees. Methods Routine plain MR of the knees followed by indirect MR arthrography was performed in 56 knees with suspected meniscal tears clinically. All cases had subsequently arthroscopic examination or operation. The sensitivity and diagnostic accordance of routine plain MR and indirect MR arthrography were compared based on the result of arthroscopic examination or operation. Results The signal intensity in the area of meniscal tears on image of indirect MR arthrography was obviously higher than that of routine plain MR. The diagnostic accordance rate of indirect MR arthrography was 78.67% while the routine plain MR was 52. 20% , and the difference was statistically significant （ X^2 = 21. 066, P 〈 0. 01 ）. Conclusion In comparison with routine plain MR findings, indirect MR arthrography demonstrates meniscus tears of the knee with better sensitivity and higher accuracy.