核磁共振诊断膝关节损伤60例临床分析

Clinical analysis of 60 patients with knee joint injury diagnosed by magnetic resonance imaging

目的:探讨核磁共振(MRI)诊断膝关节损伤的临床价值。方法:选取2014年9月至2018年9月江苏省泰州市中西医结合医院收治的60例膝关节不适患者,所有患者均行MRI检查及关节镜诊疗,以关节镜下诊断作为标准,统计MRI诊断半月板损伤与关节软骨损伤的灵敏度、特异度及准确率。结果:60例患者的120个半月板中,关节镜共检出58个半月板损伤,MRI共检出56个,漏诊8个、误诊9个。60例患者的360处软骨损伤中,关节镜检查出44处关节软骨损伤,MRI检出26处关节软骨损伤,漏诊22处、误诊4处。以关节镜诊断为金标准,MRI诊断半月板损伤的灵敏度为82.46%(47/58),特异度90.32%(56/62),准确率85.83%(103/120)。MRI诊断关节软骨损伤的灵敏度为50.00%(22/55),特异度98.73%(312/316),准确率90.56%(326/360)。结论:MRI诊断半月板及关节软骨损伤的灵敏度、特异性和准确性均较高。MRI可有效排除关节软骨损伤,但存在漏诊,尤其是对于Ⅰ级关节软骨损伤,应引起重视。

Objective: To explore the clinical value of magnetic resonance imaging(MRI) in the diagnosis of knee joint injury. Methods: Sixty patients with knee joint discomfort admitted to our hospital from September 2014 to September 2018 were selected.All patients underwent MRI examination and arthroscopic diagnosis.The sensitivity,specificity and accuracy of MRI for the diagnosis of meniscus injury and articular cartilage injury were evaluated. Results: Among 60 patients with a total of 120 meniscuses,58 meniscus injuries were detected by arthroscopy,56 meniscus injuries were detected by MRI,8 meniscus injuries were missed diagnosed and 9 meniscus injuries were misdiagnosed.Of 360 cartilage injuries in 60 patients,44 were detected by arthroscopy,26 by MRI,22 missed diagnosis and 4 misdiagnosis.According to the gold standard of arthroscopic findings,the sensitivity,specificity and accuracy of MRI in the diagnosis of meniscal injury were 82.46%(47/58),90.32%(56/62) and 85.83%(103/120).The sensitivity and specificity of MRI in the diagnosis of articular cartilage injury were 50.00%(22/55) and 98.73%(312/316),respectively.The accuracy was 90.56%(326/360). Conclusion: The sensitivity,specificity and accuracy of MRI in the diagnosis of meniscus and articular cartilage injury are high.MRI can effectively exclude articular cartilage injury,but there are missed diagnosis,especially for grade I articular cartilage injury,which should be paid attention to.