核磁共振检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的评价

Evaluation on magnetic resonance imaging in diagnosis of bone contusion and cartilage injury in tibial plateau or femoral condyle

目的探讨核磁共振检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的诊断价值。方法回顾性分析2016年10月~2018年10月在东莞市虎门医院行核磁共振检查并获得关节镜检查结果的89例疑似胫骨平台或股骨髁中骨挫伤、软骨损伤体检者的诊断学资料与临床资料,将核磁共振检查结果与关节镜检查结果对照,采用kappa系数检验核磁共振检查与关节镜检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的诊断结果的一致性,采用受试者工作特征曲线评价核磁共振检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的诊断效能。结果核磁共振检查与关节镜检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的诊断结果具有高度的一致性(k=0.797,P <0.05)。核磁共振检查对胫骨平台或股骨髁中骨挫伤、软骨损伤的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为96.25%、77.77%、97.46%、70.00%、94.38%。结论核磁共振检查对鉴别胫骨平台或股骨髁中骨挫伤、软骨损伤的病理学类型及进一步行关节镜检查或外科手术治疗具有指导意义。

Objective To explore the value of magnetic resonance imaging in diagnosis of bone contusion and cartilage injury in tibial plateau or femoral condyle. Methods The diagnostic data and clinical data of 89 patients with suspected bone contusion and cartilage injury in tibial plateau or femoral condyle who underwent magnetic resonance imaging examinations and arthroscopy in Dongguan Humen Hospital from October 2016 to October 2018 were retrospectively analyzed.Results of MRI examinations and arthroscopy were compared.kappa coefficient was used to test the consistency of the results of MRI and arthroscopy in the diagnosis of bone contusion and cartilage injury in tibial plateau or femoral condyle.The receiver operating characteristic curve was used to evaluate the diagnostic efficacy of MRI on bone contusion and cartilage injury in tibial plateau or femoral condyle. Results MRI and arthroscopy had a high degree of consistency in diagnosis of bone contusion and cartilage injury in tibial plateau or femoral condyle(k=0.797,P < 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of magnetic resonance imaging for bone contusion and cartilage injury in tibial plateau or femoral condyle were 96.25%,77.77%,97.46%,70.00% and 94.38%,respectively. Conclusion Magnetic resonance imaging has a guiding significance for the identification of pathological types of bone contusion and cartilage injury in tibial plateau or femoral condyle and further arthroscopic or surgical treatment.