磁共振成像对膝关节损伤的诊断价值及影像特征

Diagnostic value and imaging characteristics of magnetic resonance imaging in knee joint injury

目的探究膝关节损伤患者磁共振成像(MRI)、多层螺旋CT(MSCT)的影像特征,为临床诊断膝关节损伤提供参考依据。方法回顾性分析2020年1月至2023年9月厦门大学附属龙岩市中医院收治的85例疑似膝关节损伤患者的临床资料,所有患者均接受MRI、MSCT检查,以关节镜检查或手术结果为金标准,分析比较两种检查方式对膝关节损伤的检出情况、诊断效能。结果85例疑似膝关节损伤患者经关节镜检查或术后确诊为阳性75例,阴性10例。MRI检查确诊阳性73例,MSCT检查确诊66例;MRI检查对膝关节损伤诊断灵敏度、准确度均高于MSCT检查,差异有统计学意义(P<0.05)。MRI影像学表现为半月板内T2加权成像(T2WI)有高信号影,呈球状、椭圆形、片状或线条状分布;MSCT影像学标准为韧带挛缩、肿胀,韧带中断处呈低密,骨折线存在长T1及T2信号。结论与MSCT检查相比,MRI检查可以更清晰地显示膝关节损伤位置的影像学特征,明确损伤类型,灵敏度、准确度均较高,具有更高的诊断效能,有利于指导临床诊治。

Objective To explore the imaging features of patients with knee joint injury under magnetic resonance imaging(MRI)and multi-slice computed tomography(MSCT),and provide reference for clinical diagnosis of knee joint injury.Methods The clinical data of 85 patients with suspected knee joint injury admitted to Longyan Hospital of TCM Afiliated To Xiamen University from January 2020 to September 2023 were retrospectively analyzed.All patients received MRI and MSCT examination.The results of arthroscopy or surgery were used as the gold standard to analyze and compare the detec-tion and diagnostic efficacy of the two examination methods on knee joint injury.Results Of 85 patients with suspected knee joint injury,75 patients were positive and 10 patients were negative after arthroscopy or operation.MRI confirmed positive results in 73 cases and MSCT confirmed positive results in 66 cases.The diagnostic sensitivity and accuracy of MRI were higher than those of MSCT,and the differences were statistically significant(P<0.05).MRI imaging showed high signal shadow on T2-weighted imaging(T2WI)in meniscus,spherical,elliptical,lamellar or linear distribution.The imaging crite-ria of MSCT were ligament contracture and swelling,low density at the ligament break,and long T1 and T2 signals at the fracture line.Conclusion Compared with MSCT examination,MRI examination can more clearly display the imaging char-acteristics of the location of knee joint injury,identify the type of injury,have higher sensitivity and accuracy,and have higher diagnostic efficacy,which is conducive to guiding clinical diagnosis and treatment.