术前MRI评估距骨软骨损伤病灶范围的准确性及可行性研究

The accuracy and feasibility study of preoperative MRI evaluation of the lesion range of talus cartilage injury

目的探讨术前MRI评估距骨软骨损伤病灶范围的准确性及可行性。方法选取2022年1月-12月需行关节镜手术的患者42例,分别采用术前MRI和术中直接观察两种方式评估距骨软骨损伤病灶范围,并比较两种方式的准确性。结果术后6周、3个月和6个月患者的VAS评分分别为(2.11±1.25)分、(1.91±1.17)分和(1.81±0.89)分,术前为(3.48±1.68)分,术后VAS评分均低于术前(P<0.05)。术后6周的AO-FAS评分(74.22±11.38)分较术前减少(81.78±7.75)分,P=0.001,但术后3个月(91.21±4.87)分和术后6个月的AO-FAS评分(92.32±3.67)分均较术前明显增加(P<0.05)。术前MRI评估的矢状面最长径、冠状面最长径、损伤面积明显大于术中测量值(P<0.05)。结论术前MRI评估距骨软骨损伤病灶范围存在一定的准确性和可行性,但需要注意过度评估的情况,术中直接观察是更为准确的评估方式。

Objective To investigate the accuracy and feasibility of preoperative MRI in evaluating the lesion scope of talus cartilage injury.Methods Fourty-two patients requiring arthroscopic surgery were selected to evaluate the lesion scope of talus cartilage injury by preoperative MRI and direct observation during operation,and the accuracy of the two methods was compared.Results The VAS scores of patients at 6 weeks,3 months and 6 months were(2.11±1.25),(1.91±1.17)and(1.81±0.89),respectively,and before surgery were(3.48±1.68)compared.The VAS scores after surgery were all lower than before surgery(P<0.05).The score of AO-FAS at 6 weeks after operation was decreased(81.78±7.75)compared with that before operation,P=0.001,but the score of AO-FAS at 3 months after operation was increased(91.21±4.87)and at 6 months after operation was increased(92.32±3.67)compared with that before operation(P<0.05).The maximum diameter of sagittal plane,the maximum diameter of coronal plane and the area of injury evaluated by preoperative MRI were significantly higher than those measured during operation(P<0.05).Conclusion Preoperative MRI is accurate and feasible to evaluate the lesion scope of talus cartilage injury,but it is necessary to pay attention to overevaluation.Direct observation is a more accurate way to evaluate.