对比分析MRI与MSCT对膝关节隐匿性骨折的诊断价值

To Compare the Diagnostic Value of MRI and MSCT in Occult Fracture of Knee Joint

目的对比膝关节隐匿性骨折采用磁共振成像(MRI)、多层螺旋CT(MSCT)的诊断价值。方法选取医院2021年1月~2023年1月收治的疑似膝关节隐匿性骨折患者78例,且经关节镜检查,统计所有患者关节镜检查结果,以关节镜检查结果为金标准,分析膝关节隐匿性骨折采取MSCT与MRI诊断的价值。结果78例患者经关节镜检查,发现有60例确诊为膝关节隐匿性骨折,包括胫骨外侧平台骨折8例,股骨远端骨折26例,胫骨内侧平台骨折13例,髌骨骨折13例;18例膝关节周围软组织损伤;膝关节隐匿性骨折采取MRI诊断的特异度、准确性、阴性预测值、灵敏度及阳性预测值均比MSCT高(P<0.05);MSCT诊断膝关节隐匿性骨折与关节镜检查结果一致性K值为0.474,较为理想;MRI诊断膝关节隐匿性骨折与关节镜检查结果一致性K值为0.816,一致性极好。结论与MSCT相比较,膝关节隐匿性骨折使用MRI诊断的有较高的一致性、特异度、准确性、阴性预测值、灵敏度及阳性预测值。

Objective To compare the diagnostic value of occult fracture of the knee joint using magnetic resonance imaging(MRI)and multislice spiral CT(MSCT).Methods A total of 78 patients with suspected occult knee fracture admitted to our hospital from January 2021 to January 2023 were selected,and the results of arthroscopy of all patients were statistically analyzed.The value of MSCT and MRI in diagnosis of occult knee fracture was analyzed using the results of arthroscopy as the gold standard.Results 60 of 78 patients were diagnosed with occultive fracture of knee joint by arthroscopy,including lateral tibial plateau fracture in 8 cases,distal femur fracture in 26 cases,medial tibial plateau fracture in 13 cases,patella fracture in 13 cases.There were 18 cases of soft tissue injury around knee joint.The specificity,accuracy,negative predictive value,sensitivity and positive predictive value of MRI in the diagnosis of occult fracture of knee joint were higher than those of MSCT(P<0.05).The consistency between MSCT diagnosis of occult fracture of knee joint and arthroscopy was 0.474,which was ideal.The consistency K value between MRI diagnosis of occult fracture of the knee and arthroscopy was 0.816,which was very good.Conclusion Compared with MSCT,MRI has higher accuracy,consistency,negative predictive value,specificity,sensitivity and positive predictive value in the diagnosis of occult fracture of knee joint.