干骺端爆裂征在膝关节软骨下不全骨折和骨性关节炎上的鉴别价值研究

The Value of Metaphyseal Burst Sign in Differentiating Subchondral Insufficiency Fracture of the Knee from Osteoarthritis

目的:探讨干骺端爆裂征在膝关节软骨下不全骨折(SIFK)和骨性关节炎(OA)影像鉴别诊断中的价值。方法:回顾分析我院2020年1月—2023年7月经手术证实为SIFK、OA患者的影像资料并分析各自MRI图像特点,观察两者是否存在干骺端爆裂征,即病变关节髁的干骺端存在骨旁软组织水肿。结果:26例SIFK患者中24例存在干骺端爆裂征,29例OA患者中5例存在干骺端爆裂征,此征象出现率在2组间有统计学差异(χ^(2)=30.99,P=0.00)。干骺端爆裂征鉴别SIFK和OA的受试者工作特征曲线下面积为0.875(95%CI 0.77~0.98),灵敏度为82.8%,特异度为92.3%。结论:干骺端爆裂征是诊断SIFK新的间接征象,有助于与OA鉴别。

Purpose:To investigate the differential value of metaphyseal burst sign for subchondral fracture of the knee(SIFK)and osteoarthritis(OA).Methods:The imaging data of patients with SIFK and OA confirmed by surgery in our hospital from January 2020 to July 2023 were retrospectively analyzed.Metaphyseal burst sign(metaphysis paraosseous soft tissue edema)was evaluated and recorded by reading their MRI images.Results:Metaphyseal burst sign was found in 24 of 26 patients with SIFK and 5 of 29 patients with OA.There was significant difference in the occurrence rate of this sign between the two groups(χ^(2)=30.99,P=0.00).The area under receiver operating characteristic curve of metaphyseal burst sign for distinguishing SIFK and OA was 0.875(95%CI 0.77-0.98),with the sensitivity of 82.8%and specificity of 92.3%.Conclusion:Metaphyseal burst sign is a new secondary sign for the diagnosis of SIFK,which is valuable in helping to diagnose SIFK.