MRI和多层螺旋CT诊断膝关节损伤临床价值分析

The clinical efficiency and value of magnetic resonance imaging examination in the diagnosis of knee joint injury

目的探讨膝关节损伤MRI检查应用效果及临床价值。方法收治的膝关节损伤患者80例,对其临床资料进行回顾性分析,所有患者均给予CT诊断及MRI诊断,并给予患者关节镜检查以进行病理分析,对两种诊断方式的检查率及诊断准确率进行比较分析,探讨MRI的临床应用效果及价值。结果在核磁共振成像诊断中,其中27例为关节腔积液,占33.8%,23例为半月板损伤,占28.8%,17例为韧带损伤,占21.3%,13例为骨质改变,占16.3%。在核磁共振检查中,其中存在关节腔积液的患者主要表现为长T_1和长T_2信号;存在半月板损伤者主要表现为三角形的低信号影;存在韧带损伤的患者主要变现为条状低信号变粗或者是病灶的边缘模糊,其中T_1WI呈现混杂信号,T_2WI呈现高信号;存在骨质改变的患者主要变现为T_1WI呈现高信号,T_2WI呈现低混杂信号。上述检查结果均经关节镜检查以及手术证实。与CT诊断准确率相比,MRI诊断的准确率明显提高,差异具有统计学意义(P<0.05)。结论 MRI检查膝关节损伤诊断准确率高,临床应用价值高。

Objective To perform the magnetic resonance imaging（ MRI） on patients with knee injuries so as to explore the efficiency and value of MRI in clinic. Methods 80 patients with injury of knee joint were selected in hospital from June 2012 to June 2016 and the clinical data were analyzed retrospectively,all patients were subjected to CT,MRI,and arthroscopy so as to perform the pathological analysis in those patients. And then,the inspection rate and diagnostic accuracy rate o the two kinds of diagnostic modalities were comparatively analyzed and,the clinical application efficiency and value of MRI were explored. Results In the diagnosis with MRI,27 cases presented with articular cavity effusion,accounting for 33. 8%,23 cases with meniscus injury,accounting for 28. 8%,17 cases with ligament damage,accounting for 21. 3%,and 13 cases with bone change,accounting for 16. 3%. By means of MRI,patients with articular cavity effusion mainly showed long T1 and long T2 signal,the patients with meniscus injury mainly showed the low signal like the triangle shadow,the patients with ligament injury mainly showed low signal like strips with edge blur or coarsening lesions,in which the T1WI presented the mixed signals and the T2WI presented high signal,and the patients with bone changes mainly showed high signal on T1WI and low mixed signals on T2WI. These results were confirmed by arthroscopy and surgery. Compared with the diagnostic accuracy with CT,the diagnostic accuracy with MRI was obviously improved,with statistically significant difference（ P〈0. 05）. Conclusion Using MRI of the diagnosis of knee joint injury is able to clearly demonstrate the pathological changes and damage degree. This modality possesses the higher diagnostic accuracy and the advantage of high resolution,which can provide scientific basis for clinical treatment and prognostic assessment,with higher value in clinical application.