核磁共振诊断膝关节半月板损伤的假阳性干扰因素探讨

Confounding Factors of False-Positive MRI Diagnosis in Knee Meniscus Injury

目的:探讨导致核磁共振诊断膝关节半月板损伤的假阳性干扰因素;材料与方法:收集临床表现可疑膝关节损伤的病例164例,对其MR诊断结果和关节镜或手术诊断结果进行比较;结果:本组MR诊断半月板损伤9例假阳性结果,MR诊断半月板损伤的敏感度为96.7%,特异度为91.3%,准确度为97.6%,不同级别诊断的符合率分别为1级98.3%,2级90.7%,3级91.1%,4级94.7%,出现假阳性结果的病例中扫描中有轻微抖动、未行对侧比较扫描、2-3级半月板损伤比例较高;结论:患者检查扫描时的不自主运动、未能与健侧膝关节进行比较分析、以及损伤程度的级别不同、膝关节镜检查的盲区效应、放射诊断医师的认知程度等等都有可能导致假阳性的结果产生。

Purpose： Investigate the confounding factors leads to false-positive MRI diagnosis of knee meniscus injury ; Materials and Methods： Selected 164 cases with clinical manifestations who were suspected as knee injury, and its MR diagnosis and arthroscopic or surgical diagnosis results were compared; Results： 9 cases were false-diagnosis as meniscal teared. The sensitivity was 96. 7% and a specificity of 91.3% and accuracy was 97.6% of MR diagnosis, the compliance rate of different levels of diagnosis were 98.3% in a 2 level 90. 7% 3 91.1% 4 94. 7% respectively, With a higher proportio- no of cases with false-positve results in slight jitter in the scan , short of contralateral scan , 2- 3 levels of meniscus; Con- clusion： Check scanning in patients with involuntary movements , failed the contralateral knee for comparative analysis, as well as the level of damage , blind effect of knee arthroscopy , radiologists and physicians awareness can cause false-positive diagnosis of knee damage.