MRI对膝关节韧带、半月板及软骨损伤的分级诊断的临床意义

Clinical Significance of MRI for the Diagnosis and Damage Classification of Ligament,Meniscus and Cartilage

目的考察MRI对膝关节半月板、韧带及软骨损伤的分级诊断的临床意义。方法收集2010年5月～2013年4月在笔者医院进行治疗的186例膝外伤病患的MRI资料，行MRI检查进行膝关节半月板、韧带及软骨损伤分级，以关节镜检查损伤分级为金标准。结果ACL损伤病患共65例，损伤类别为5级，ACLI、Ⅱ、Ⅲ和Ⅳ级损伤的准确性、特异性和敏感度分别为92．3％、98．0％、73．3％；90．8％、89．4％、94．4％；86．2％、88．2％、78．6％；95．4％、98．3％、66．7％。半月板损伤病患69例，损伤类别为5级，半月板损伤分级I、Ⅱ、Ⅲ和Ⅳ级损伤的准确性、特异性和敏感度分别为97．1％、98．1％、93．3％；89．9％、91．8％、85．0％；92．8％、94．8％、81．8％；94．2％、96．7％、75．0％。关节软骨损伤病患52例，损伤类别为5类，关节软骨损伤分级I、Ⅱ、Ⅲ和Ⅳ级损伤的准确性、特异性和敏感度分别为92．3％、95．0％、83．3％；90．4％、94．4％、81．3％；86．5％、88．4％、77．8％；94．2％、97．8％、71．4％。结论ACL、半月板及关节软骨损伤在MRI的表现均可分为5级。MRI对ACL、半月板及关节软骨损伤分级评估，选择合适的治疗方案具有无法替代的优势。

Objective To investigate the clinical significance of MRI for the diagnosis and damage classification of ligament, menis- cus and cartilage. Methods From May 2010 to April 2013, MRI data of 186 patients with knee trauma were collected in our hospital. Results Sixty - five cases with anterior cruciate ligament （ACL） injury were categorized in to 5 grades. Accuracy, specificity and sensi- tivity of the ACL I , II, I and 1V injury were 92.3% , 98.0% , 73.3% ; 90.8% , 89.4% , 94.4% ; 86.2% , 88.2% , 78.6% ; 95.4% , 98.3% , 66.7% , respectively. Sixty -nine cases with meniscus injury were categorized in to 5 grades. Accuracy, specificity and sensitivity of the meniscus I , II, 111 and IV injury were 97.1% , 98.1% , 93.3% ; 89.9% 91.8% , 85.0% ; 92.8% , 94.8% , 81.8% ; 94.2% , 96.7% , 75.0% , respectively. Fifty - two cases of articular cartilage injury were categorized in to 5 grades. Accuracy, specificity and sensitivity of the articular cartilage I , II, 111 and IV injury were 92.3% , 95.0% , 83.3% ; 90.4% 94.4% , 81.3% ; 86.5% , 88.4% , 77.8% ; 94.2% , 97.8% , 71.4% , respectively. Conclusion ACL, meniscus and articular cartilage injury can be divided into 5 classes by MRI. Selecting the appropriate treatment for ACL, meniscus and articular cartilage injury is dependent on the grading and assessment of MRI.