MRI常规序列联合DWI评估膝关节软骨损伤的临床分析

Clinical analysis of conventional MRI sequences combined with DWI to evaluate knee cartilage injury

目的:探讨磁共振成像(Magnetic resonance imaging,MRI)常规序列联合弥散加权成像(Diffusion weighted imaging,DWI)评估膝关节软骨损伤的价值。方法:选取2021年3月-2023年3月期间于本院就诊时主述症状高度疑似膝关节软骨损伤的164例患者作为研究对象。所有患者均接受MRI常规序列扫描,并接受DWI检查。以关节镜检查方法作为膝关节软骨损伤诊断的金标准。统计MRI常规序列、DWI检查单独及联合诊断膝关节软骨损伤的结果;分析单一MRI常规序列检查、单一DWI检查以及联合检查诊断膝关节软骨损伤的价值。结果:经关节镜检查结果显示,164例高度疑似膝关节软骨损伤患者最终确诊55例,占比33.54%。MRI常规序列、DWI单独及联合诊断膝关节软骨损伤均与金标准有较好的一致性(P<0.05)。MRI常规序列联合DWI诊断膝关节软骨损伤的灵敏度、阴性预测值均高于二者单独诊断(P<0.05);但三者间特异度、准确率及阳性预测值比较均无明显差异(P>0.05)。结论:MRI常规序列与DWI检查诊断膝关节软骨损伤均有一定价值,但联合诊断可提高整体的灵敏度与阴性预测。

Objective:To evaluate the value of conventional Magnetic resonance imaging(MRI)combined with Diffusion weighted imaging(DWI)in evaluating knee cartilage injury.Methods:164 patients with symptoms highly suspected of knee joint cartilage injury were selected from March 2021 to March 2023.All patients underwent routine sequence MRI scans and DWI examination.Arthroscopy is the gold standard for the diagnosis of knee cartilage injury.The results of routine MRI sequence,DWI examination alone and combined diagnosis of knee cartilage injury were analyzed.To analyze the value of single MRI routine sequence examination,single DWI examination and combined examination in the diagnosis of knee cartilage injury.Results:According to the results of arthroscopy,55 cases of 164 patients with highly suspected knee cartilage injury were confirmed,accounting for 33.54%.The conventional MRI sequence,DWI alone and combined diagnosis of knee cartilage injury were in good agreement with the gold standard(P<0.05).The sensitivity and negative predictive value of conventional MRI sequence combined with DWI in the diagnosis of knee cartilage injury were higher than those of both alone(P<0.05).However,there were no significant differences in specificity,accuracy and positive predictive value among them(P>0.05).Conclusion:Both routine MRI sequence and DWI examination have certain value in the diagnosis of knee cartilage injury,but the combined diagnosis can improve the overall sensitivity and negative prediction.