MRI诊断前交叉韧带损伤的价值探讨:与关节镜对照研究

Value of MRI in the diagnosis of anterior cruciate ligament injury:a comparative study with arthroscopy

目的以关节镜诊断结果作为金标准,探讨核磁共振(MRI)在诊断前交叉韧带(ACL)损伤中的价值。方法选择2016年1月至2019年1月昆明市延安医院呈贡医院疑诊为前交叉韧带损伤的61例患者,均接受MRI检查及关节镜检查。分析MRI对ACL损伤的诊断价值。结果MRI与关节镜诊断结果比较,差异无统计学意义(McNemar检验显示双侧P=0.625)。MRI与关节镜对ACL损伤的诊断结果一致性极好(Kappa=0.861),MRI对ACL损伤诊断的灵敏度、特异度、误诊率、漏诊率、阳性预测值、阴性预测值分别为97.30%(36/37)、87.50%(21/24)、12.50%(3/24)、2.70%(1/37)、92.31%(36/39)、95.45%(21/22)。结论MRI作为一种非创伤性检查手段,对ACL损伤的诊断具有较高的灵敏度、特异度及准确性,与关节镜检查结果的一致性较好,可为临床早期诊断与及时治疗提供重要的参考价值。

Objective To explore the value of magnetic resonance imaging(MRI)in the diagnosis of anterior cruciate ligament(ACL)injury with arthroscopic findings as the gold standard.Methods From January 2016 to January 2019,61 patients suspected of ACL injury in Chenggong Hospital of Kunming Yan'an Hospital were selected and examined by MRI and arthroscopy.The diagnostic value of MRI in ACL injury was analyzed.Results There was no significant difference between the diagnostic results of MRI and arthroscopy(Mc Nemar test showed bilateral P=0.625).The diagnostic results of MRI and arthroscopy for ACL injury were in good agreement(Kappa=0.861).The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,positive predictive value and negative predictive value of MRI in the diagnosis of ACL injury were 97.30%(36/37),87.50%(21/24),12.50%(3/24),2.70%(1/37),92.31%(36/39),95.45%(21/22)respectively.Conclusion As a non-traumatic examination method,MRI has high sensitivity,specificity and accuracy in the diagnosis of ACL injury.It is in good agreement with the results of arthroscopy.It can provide important reference value for early clinical diagnosis and timely treatment.