磁共振对膝关节软骨损伤分级诊断的研究价值

The Value of MRI in Grading Diagnosis of Cartilage Injury of Knee Joint

目的探讨MRI对膝关节软骨损伤分级诊断的应用价值。方法搜集本院56例经关节镜或手术证实膝关节软骨损伤患者的MRI和临床资料,依据Outerbridge分级标准对膝关节软骨损伤进行分级诊断,将MRI诊断结果与关节镜或手术结果进行对比分析。结果本组56例患者共计336个软骨面,MRI诊断为I级26处、Ⅱ级28处、Ⅲ级58处、IV级43处;关节镜诊断为I级27处、Ⅱ级27处、Ⅲ级58处、IV级43处;以关节镜分级为标准,MRI诊断膝关节软骨损伤的敏感度为97.45%,特异度为98.32%,准确度为97.92%,阴性预测值为97.78%,阳性预测值I~Ⅳ级分别为69.23%、75%、100%、100%。与关节镜结果相比,MRI诊断膝关节软骨损伤一致性极佳（Kappa=0.909）,差异有统计学意义P〈0.05。结论磁共振成像技术能够客观、可靠地显示膝关节软骨损伤的部位及损伤程度,能为临床提供可靠的依据,可对膝关节软骨损伤进行术前分级诊断并值得广泛推广和应用。

Objective To investigate the value of M1KI in grading diagnosis of cartilage mjuW of knee joint. Meehods The MRI and clinical date of 56 patients with cartilage injury of knee joint confirmed by arthroscopy or operation in our hospital were collected. The all cartilage injury was graded and diagnosed by the Outerbridge Classification Criterion,and we compared the results of MP.I imaging with those by arthroscopy or operation. Results Among all 336 joint surfaces of 56 cases in this group, Ⅰ , Ⅱ , Ⅲ IV injury diagnosed by MRI imaging was 26, 28, 58, 43; while the results by arthroscopy was 27, 27, 58, 43.Taking the classification diagnostic results of arthroscopy as standards,the sensitivity, specificity, accuracy rate of MILl imaging for cartilage injury of knee joint was 97.45%, 98.32%, 97.92%, negative predictive value was 97.78%,and positive predictive value of Ⅰ . Ⅱ ,Ⅲ, IV injury was 69.23%, 75%, 100%, 100%.Compared with the results by arthroscopy,the MRI classification diagmostic results of cartilage injury of knee joint have superb consistency （ Kappa=0.909 ） ,besides, The difference was statistically significant（P〈0.05）. Coillusion MRI can objectively and reliably display the location and degree of the cartilage injury of knee joint, provide clinic with the reliable evidence, grade and diagnose cartilage injury of knee joint before operation and be worth popularizing and applying widely.