膝关节半月板半脱位的MRI测量与诊断

Measurements and diagnosis of the meniscal subluxation of knee joint on MRI

目的探讨膝关节半月板半脱位MRI测量方法与表现,提高对该病的认识和诊断准确性。方法回顾性分析200例膝关节症状患者的临床和影像资料,该批患者均行单膝关节MRI检查,采用统一的检查和测量方法,分析膝关节内、外侧半月板MRI表现(正常、退变、撕裂)与半月板半脱位发生率的关系。结果内侧半月板:MRI表现正常的31例,其中发生半脱位1例;MRI表现为退变的86例,发生半脱位14例;MRI表现为撕裂的52例,半脱位16例。内侧半月板不同MRI表现半脱位发生率的差别有统计学意义(χ2=7.261,P<0.05)。外侧半月板:MRI表现正常的41例,其中半脱位1例;MRI表现为退变的95例,半脱位8例;MRI表现为撕裂的46例,半脱位9例。外侧半月板不同MRI表现半脱位发生率的差别有统计学意义(χ2=6.079,P<0.05)。内、外侧半月板半脱位的发生率的差别有统计学意义(χ2=3.930,P<0.05)。结论选择合理的测量方法,有利于膝关节半月板半脱位的诊断;膝关节内、外侧半月板撕裂后半月板半脱位的发生率增大。

Objective To explore the measurements and appearance of meniscal subluxation on MRI and improve the diagnosing accuracy.Methods MRI of 200 cases with symptom in the knees were evaluated retrospectively,and were examinied and measured in the same way.We analyzed the relation ship between the appearance of medial or lateral meniscus on MRI（including normal,degeneration and tearing）and the incidence of meniscal subluxation.Results The cases of normal,degeneration and tearing of medial meniscus were 31,86 and 52,respectively,and accordingly,the cases of meniscal subluxation were 1,14 and 16,respectively.The difference in incidence of meniscal subluxation among different appearance on MRI showed statistical significance（χ2=7.261,P0.05）.The cases of normal,degeneration and tearing of lateral meniscus were 41,95 and 46,respectively,and accordingly,the cases of meniscal subluxation were 1,8 and 9,respectively.The difference in incidence of meniscal subluxation among different appearance on MRI showed statistical significance（χ2=6.079,P0.05）.Furthermore,the difference in incidence between medial and lateral meniscus had statistical significance（χ2=3.930,P0.05）.Conclusions It is very useful for the diagnosis of meniscal subluxation by selecting the rational measurements.Moreover,if the meniscus was teared,the possibility of meniscal subluxation is increasing.