MRI诊断膝关节内、外侧半月板损伤的准确性分析

Analysis the misdiagnosis and the differences between medial meniscus and lateral meniscus injuries with MRI

【目的】分析和探讨磁共振成像(Magnetic resonance imaging,MRI)诊断膝关节内、外侧半月板损伤的准确性及误、漏诊原因。【方法】搜集分析经关节镜证实的183例(183个膝关节)膝关节内、外侧半月板MRI资料,分别对MRI诊断内、外侧半月板损伤的准确性指标进行统计并分析内、外侧半月板误诊程度、漏诊类型是否一致。【结果】183例患者中,MRI诊断内侧半月板损伤误诊率18.58%,漏诊率8.74%,灵敏度68.63%,特异度74.24%,准确率72.68%,正确指数42.87%;外侧半月板损伤误诊率14.75%,漏诊率13.11%,灵敏度63.64%,特异度76.92%,准确率72.13%,正确指数49.05%。内、外侧半月板的误诊程度构成差异无统计学意义(P>0.05)。内、外侧半月板的漏诊类型构成不全相同。【结论】MRI诊断内、外侧半月板损伤误漏诊原因是半月板信号较难鉴别,内侧半月板解剖结构复杂时,诊断医师容易主观或客观的误、漏诊。

【Objective】To investigate the accuracy of MRI in diagnosing internal meniscus and lateral meniscus of knee injury and the causes which mistakenly diagnosed and missed diagnosis.【Methods】183 patients with MRI who had underwent knee arthroscopy performed in internal meniscus and lateral meniscus,then independently calculate the accuracy and the difference of the extent of mistaken in diagnosis and the configurations of missing diagnosis in which.【Results】For the accuracy of MRI in diagnosed internal meniscus injuried,the misdiagnosing rate, lost diagnostic rate, sensitivity, specificity, accuracy rate, Youden＇s index were 18.58%,8.74%,68.63%,74.24%,72.68% and 42.87%, respectively. For lateral meniscus injuried, the values were 14.75%,13.11%,63.64%,76.92%,72.13% and 49.05%.There were no statistical differences between the internal meniscus and the lateral meniscus in the extent of mistakening in diagnosis（P0.05）. There were differences between the internal meniscus and the lateral meniscus in the configurations of misseding diagnosis.【Conclusions】When the MRI in diagnosing internal meniscus and lateral meniscus of knee injury would mistakenly diagnose and missing diagnosis,the causes is diagnostician would be supposition in which the signal shows not distinct,and the complicated anatomy.