ADT、Lanchman试验与MRI对于诊断前交叉韧带断裂的可靠性研究

Reliability Study of Diagnosing Anterior Cruciate Ligament Rupture by Using ADT,Lanchman Test and MRI

目的:回顾性分析因怀疑前交叉韧带断裂而住院行膝关节镜检查治疗术的患者当中,术前前抽屉试验(ADT)、Lanchman试验、核磁共振成像(MRI)检查提示韧带断裂的阳性率、敏感性以及特异性,讨论前交叉韧带断裂的最敏感非手术检查方法。方法:通过搜集近10年内我院骨科关节镜术中确诊的前交叉韧带损伤患者的临床病例资料,分析术前ADT、Lanchman试验及MRI检查数据,统计各种检查结果的阳性率、敏感性和特异性,比较各种检查方法的差异。结果:本次研究共搜集到210个关节镜手术病例,术前相关检查的确诊前交叉韧带断裂的阳性率依次为:ADT:61.4%;Lanchman试验:69.5%;MRI:87.1%。敏感性依次为:ADT:61.5%;Lanchman试验:69.5%;MRI:91.4%。特异性依次为:ADT:60.9%;Lanchman试验:69.6%;MRI:52.2%。结论:ADT、Lanchman试验、MRI对于诊断前交叉韧带断裂均存在偏差,临床诊疗过程中应将三种检查结果联合参考作为前交叉韧带断裂的诊断依据。

Objective： The aim of this study was to discuss and develop the most sensitive non operative method for anterior cruciate ligament rupture. Retrospective analysis was performed on patients who underwent arthroscopic knee arthroscopy for anterior cruciate ligament rupture. Before operation, the positive rate of ligament rupture was tested by using anterior drawer test （ADT）, Lanchman test and nuclear magnetic resonance imaging （MRI） examination. Methods： Collect the clinical data of the patients with anterior cruciate ligament injury diagnosed in department of orthopedics in our hospital during the past 10 years. Analysis ADT, Lanchman test and MRI before operation, then compare the statistical difference of the positive rate and sensitivity and specificity of each correlation. Results： 210 cases of arthroseopie surgery were collected in this research. The positive rates of diagnosis of preoperative examinations were as follows： ADT： 61.4 %, Lanchman： 69.5 %, MRI： 87.1%. Sensitivity test are as follows： ADT： 61.5 %, Lanehman： 69.5 %, MRI： 91.4 %. Test specific are as follows： ADT： 60.9 %, Lanchman： 69.6 %, MR/： 52.2 %. Conclusions： ADT, Lanchman test, MRI for the diagnosis of anterior crueiate ligament rupture are deviation. In order to get the most accurate diagnosis of anterior cruciate ligament rupture, the clinical diagnosis and treatment process should be combined with all kinds of test results.