膝关节前交叉韧带和半月板损伤MRI和关节镜诊断的比较

Comparison of MRI and arthroscopy examination for diagnosing anterior cruciate ligament and meniscal injuries in knee joint

目的探讨MRI对前交叉韧带(ACL)和半月板损伤的诊断准确率及其对临床治疗的指导意义。方法82例临床诊断为ACL或半月板损伤的患者常规行MRI和关节镜检查。以关节镜诊断为金标准,对MRI诊断ACL和半月板损伤的灵敏度、特异度、准确度(符合率)、Youden指数、阳性预测值、阴性预测值、kappa值进行分析。结果MRI诊断半月板损伤的灵敏度、特异度、准确度分别为84.4%,94.0%和90.2%,诊断ACL损伤的灵敏度、特异度、准确度分别为97.3%,93.3%和95.1%。MRI和关节镜对于半月板和ACL损伤具有极好的诊断一致性,kappa值分别为0.79和0.90。结论MRI诊断ACL和半月板损伤具有较高的准确度,应作为诊断ACL和半月板损伤的首选检查方法。

Objective To explore the accuracy of magnetic resonance imaging （MRI）in the diagnosis of anterior cruciate ligament （ACL） and meniscal injuries and its clinical value. Methods MRI and arthroscopy were performed in eighty-two patients clinically diagnosed as ACL and meniscal injuries. Sensitivity, specificity, accuracy, positive and negative predictive values, Youden value and kappa agreement measures of MRI for ACL and meniscal injuries were investigated with the result of arthroscopy as golden standard. Results The sensitivity, specificity and accuracy of MRI for meniscal injuries were 84.4% ,94.0% ,90.2% ,respectively. The sensitivity, specificity and accuracy of MRI for ACL were 97.3% ,93.3% and 95.1%, respectively. MRI showed excellent kappa agreements （0.79 and 0.90） for both menisci and ACL with the results of arthroscopy. Conclusion MRI shows a high accuracy in the diagnosis of ACL and meniscal injuries, and should be used as a primary tool for diagnosing ACL and meniscal injuries.