膝关节内外侧半月板前后角、前交叉韧带的MRI图像及其诊断价值

MRI of anterior and posterior horns of medial and lateral meniscus and anterior cruciate ligament of knee joint and their diagnostic value

目的:分析膝关节内外侧半月板前后角及前交叉韧带的MRI图像及其诊断价值,为临床提供参考。方法:对我院2022年1-12月收治的240例急性膝关节外伤患者的病例资料进行回顾性分析,首先对患者行MRI,然后行关节镜。对MRI图像的诊断价值进行分析。结果:MRI诊断半月板撕裂的敏感性为98.47%,特异性为89.47%,准确率为97.86%,MRI和关节镜诊断半月板撕裂的结果有较高的一致性(Kappa值=0.838);MRI诊断前交叉韧带撕裂的敏感性为98.47%,特异性为88.89%,准确率为97.86%,MRI和关节镜诊断前交叉韧带撕裂的结果有较高的一致性(Kappa值=0.831);半月板撕裂组内外侧前后角、体部各部位的高度和宽度均显著高于未撕裂组(P<0.05);前交叉韧带撕裂组的交叉韧带角度(PCL)和PCL弯曲指数显著低于未撕裂组(P<0.05)。结论:MRI对前交叉韧带及半月板撕裂有重要诊断价值,可以为后续治疗提供准确影像学依据,内外侧半月板前后角位置的改变以及PCL和PCL弯曲指数的变化,可作为半月板和前交叉韧带撕裂诊断的重要参考。

Objective:To analyze the images and diagnostic value of MRI of anterior and posterior horns of medial and lateral meniscus and anterior cruciate ligament of knee joint so as to provide clinical reference.Methods:The data of 240 patients with acute knee joint trauma admitted to our hospital from January 2022 to December 2022 were retrospectively ana-lyzed.The patients underwent MRI and arthroscopy,and then analyzed the diagnostic value of MRI images.Results:The sen-sitivity,specificity and accuracy rate of MRI were 98.47%,89.47%and 97.86%in the diagnosis of meniscus tear.Kappa test showed high consistency between MRI and arthroscopy in the diagnosis of meniscus tear(Kappa=0.838).The sensitivity,speci-ficity and accuracy rate of MRI in diagnosing anterior cruciate ligament(ACL)tear were 98.47%,88.89%and 97.86%.MRI was highly consistent with arthroscopy in ACL tear diagnosis(Kappa=0.831).The medial and lateral anterior and posterior horns and height and width of each body part in meniscus tear group were significantly higher than those in non-tear group(P<O0.05).The posterior cruciate ligament(PCL)and PCL flexure index in ACL tear group were significantly lower than those in non-tear group(P<0.05).Conclusion:MRI has important diagnostic value on ACL and meniscus tear,which can provide accu-rate images for subsequent treatment.The changes of positions of anterior and posterior horns of medial and lateral meniscus as well as the changes of PCL and PCL flexure index can be used as important reference for the diagnosis of meniscus and anterior cruciate ligament tear.