退行性膝关节炎关节软骨损伤的MRI表现

The appearances of MRI in degenerative knee articular cartilage injury

目的评价不同观察者对退行性膝关节炎关节软骨损伤MRI诊断一致性,探讨退行性膝关节炎的关节软骨损伤MRI表现特点及临床意义。方法由两位有经验的医生回顾性分析68例诊断退行性膝关节炎的髌骨、股骨内、外髁、股骨髁间滑车、胫骨内、外侧平台关节软骨408处关节软骨的MRI图像信号及形态改变进行损伤分级,所得结果进行Kappa统计分析。结果(1)甲医生:408处关节软骨损伤0级34处、I级59处、II级80处、III级161处、Ⅳ级74处;III级为39.5%。乙医生:408处关节软骨损伤0级30处、I级68处、II级72处、III级160处、Ⅳ级78处;III级为39.2%。以髌骨后缘、股骨髁及胫骨平台内处多受损伤。(2)68例都伴有1种或1种以上不同程度的关节其它相关结构病变。结论MRI对关节软骨损伤诊断一致性良好,可较为准确地对退行性膝关节炎的关节软骨损伤分级;有其它检查方法无可比拟的显示关节其它相关结构的病变的优势。

Objective To evaluate different observers＇ agreement about the diagnosis of degenerative knee articular cartilage injury with MRI and to explore the MRI manifestations and clinical significance of the disease. Methods MR imaging signals and configuration change of articular cartilages in 408 spots including patella, intercondylus, medial lateral femoral medullar, medial and lateral tibia plateau in 68 patients diagnosed as degenerative osteoarthrosis were retrospectively analyzed and categorized by two experienced radiologists. Then the two radiologists＇ results were used to make the Kappa statistics and analysis. Results The first results： （1）Of all 408 spots of articular cartilage injury in 68 cases, 34 spots were grade 0, 59 spots grade I, 80 spots grade 11, 161 spots grade III, 74 spots grade IV. The second results： Of all 408 spots of articular cartilage injury in 68 cases, 30 spots were grade 0, 68 spots grade I, 72 spots grade 11, 160 spots grade HI, 78 spots grade IV. （2） 68 cases were accompanied by one or more than one kind of different levels of other joint-related structure injury. Conclusion MRI is of great value in the diagnostic agreement of articular cartilage injury and has the remarkable advantages in clearly diplaying the lesions of neighboring structures.