前交叉韧带损伤MRI与关节镜诊断临床价值分析

Investigation of clinical value for MRI and arthroscope in diagnosis of an-terior cruciate ligament

目的：探讨前交叉韧带（ACL）损伤患者实施磁共振MRI与关节镜诊断的临床价值，对比诊断吻合性，为临床选择诊断方法提供参考。方法选择2011年7月～2014年7月ACL损伤疑似患者40例（44例伤膝），所有患者于手术治疗前MRI磁共振扫描，术中实施关节镜诊断，对比MRI与关节镜检诊断结果。结果关节镜下诊断10例正常，损伤34例，损伤膝盖中完全断裂23例，部分断裂11例；MRI影像学诊断11例正常，损伤33例，伤膝中部分断裂13例，完全断裂20例；MRI诊断灵敏度为91.18%（31/34），特异度为72.73%（8/11），假阳性率为4.55%（2/44），假阴性率为6.82%（3/44），准确率为88.64%（39/44），MRI与关节镜诊断一致性检测Kappa=0.762，P=0.001。结论 MRI诊断前交叉韧带损伤未断裂及完全断裂准确率高，提示部分断裂时需结合其他诊断方式确认是否为完全断裂。

Objective To investigate clinical value of MRI and arthroscope in diagnosis of anterior cruciate ligament, and to compare diagnosis accuracy and provide a reference for clinical diagnosis. Methods A total of 40 suspected pa-tients with anterior cruciate ligament were selected from July 2011 to July 2014, MRI were used in all patients before surgeries for diagnosing, and arthroscope was used during surgeries, results were compared between MRI and arthro-scope application. Results 10 cases of 44 suspected ACL knees were detected normal under arthroscope, the other 34 cases were detected injured, partial tear 11 cases while complete tear 23 cases;Under MRI 11 cases were detected nor-mal, the other 33 cases were detected injured, partial tear 13 cases while complete tear 20 cases. The sensitivity of MRI was 91.18%（31/34）, the specificity rate was 72.73%（8/11）, false positive rate was 4.55%（2/44）, false negative rate was 6.82%（3/44）, accuracy rate was 88.64% （39/44） （Kappa=0.762, P=0.001）. Conclusion MRI is an accurate way to diagnose anterior cruciate ligament, particularly for absent ACL and complete tear, for partial tear ACL patients MRI should combine with other diagnosis to decrease false results.