[1]王平,金哲峰.磁共振成像在膝关节软骨损伤诊断中的价值评价[J].中医正骨,2011,23(06):13-15.
　WANG Ping*,JIN Zhe-feng.*.Evaluation on the value of magnetic resonance imaging in the diagnosis of cartilage lesions in knee joint[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(06):13-15.
点击复制

磁共振成像在膝关节软骨损伤诊断中的价值评价()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期数:
2011年06期
页码:
13-15
栏目:
临床研究
出版日期:
2011-06-30

文章信息/Info

Title:
Evaluation on the value of magnetic resonance imaging in the diagnosis of cartilage lesions in knee joint
作者:
王平; 金哲峰
天津中医药大学第一附属医院,天津 300193
Author(s):
WANG Ping*; JIN Zhe-feng.*
The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China
关键词:
膝关节 软骨疾病 磁共振成像 关节镜检查 回顾性研究
Keywords:
Knee joint;  Cartilage diseases;  Magnetic resonance imaging;  Arthroscopy;  Retrospective studies
摘要:
目的:评价磁共振成像各序列在膝关节软骨损伤诊断中的价值,为临床医生诊断和治疗膝关节软骨损伤提供可靠的依据。方法:回顾性分析106例膝关节病变患者关节镜术前磁共振成像的检查结果与关节镜检查结果。将每个膝关节的软骨面分成6个部分:髌骨、股骨滑车、股骨内髁面、股骨外髁面、胫骨平台内侧面和胫骨平台外侧面。根据关节镜检图片和手术记录对各个观察面的软骨损伤进行分级,并以此为标准,评价术前MRI常规快速自旋回波T1加权像、快速自旋回波T2加权像及三维脂肪抑制扰相梯度回波3个序列对关节软骨损伤的诊断和病变分级报告。采用诊断试验的一致性检验对MRI各序列在膝关节软骨损伤诊断中的价值进行评价。结果:在与关节镜诊断的一致性上,快速自旋回波T1加权像序列和快速自旋回波T2加权像序列一致性中等(Kappa=0.534,P=0.000; Kappa=0.581,P=0.000); 三维脂肪抑制扰相梯度回波序列的一致性非常好(Kappa=0.850,P=0.000); 在敏感度和准确度方面,三维脂肪抑制扰相梯度回波(96.5%,94.1%)>快速自旋回波T2加权像(62.8%,73.6%)>快速自旋回波T1加权像(51.6%,69.2%); 三者的特异度相差较小。结论:磁共振成像三维脂肪抑制扰相梯度回波序列诊断关节软骨损伤病变,具有较高的准确性和敏感度,与关节镜诊断具有良好的一致性,是诊断关节软骨损伤的较好方法。
Abstract:
Objective:To make an evaluation on the value of every sequence of magnetic resonance imaging(MRI)in the diagnosis of cartilage lesions in knee joint,and to provide the reliable basis for the clinicians in the diagnosis and treatment of knee cartilage lesions.Methods:MRI findings before arthroscopy and arthroscopic findings of 106 patients with knee lesions were analyzed retrospectively.Every chondral surface of knee joint was divided into the following 6 parts as patellar surface,surface of femoral trochlea,surface of medial condyle of femur,surface of lateral condyle of femur,medial surface of tibial plateau and lateral surface of tibial plateau.The degree of cartilage lesions of each observational surface was evaluated and classified according to arthroscopic pictures and operation records,and the results were regarded as the criteria to evaluate the reports of diagnosis and lesions classification for the articular cartilage injury affected from the following 3 sequences as T1-weighted images of conventional fast spin-echo(FSE-T1WI),T2-weighted images of conventional fast spin-echo(FSE-PD/T2)and three-dimensional fat-suppressed spoiled gradient echo(FS-3D-SPGR)in preoperative MRI.The values of every MRI sequence in the diagnosis of cartilage lesions in knee joint were evaluated by using the consistency check of diagnostic test.Results:FSE-T1WI sequence and FSE-PD/T2 sequence had mid-level consistency with the arthroscopic diagnosis respectively(Kappa=0.534,P=0.000; Kappa=0.581,P=0.000),while FS-3D-SPGR sequence had high-level consistency with the arthroscopic diagnosis(Kappa=0.850,P=0.000).On the aspect of sensitivity and accuracy,there was a relationship as:FS-3D-SPGR(96.5%,94.1%)>FSE-PD/T2(62.8%,73.6%)>FSE-T1WI(51.6%,69.2%); and there was a less difference in specificity among the 3 sequences.Conclusion:FS-3D-SPGR sequence in MRI is a better method in the diagnosis of knee cartilage lesions for its higher sensitivity and accuracy and good consistency with the arthroscopic diagnosis.

参考文献/References:

[1] Recht MP,Kramer J,Marcelis S,et al.Abnormalities of articular cartilage in the knee:analysis of available MR techniques[J].Radiology,1993,187(2):473-478.
[2] OUTERBRIDGE RE.FURTHER STUDIES ON THE ETIOLOGY OF CHONDROMALACIA PATELLAE[J].J Bone Joint Surg Br,1964,46(5):179-190.
[3] Mlynarik V,Szomolanyi P,Toffanin R,et al.Transverse relaxation mechanisms in articular cartilage[J].J Magn Reson,2004,169(2):300-307.
[4] 何翠菊,李松泊,白希壮,等.膝关节透明软骨损伤的MR成像序列比较及与关节镜对照研究[J].实用放射学杂志,2003,19(1):53-56.
[5] 罗小平,华兰娇,丁爱民,等.中低磁场3D-FS-SPGR结合三维重建技术对关节软骨损伤的诊断价值[J].中国临床医学影像杂志,2005,16(3):153-155.
[6] 朱宝林,亓建洪,张经健,等.关节软骨病损的磁共振成像及其与大体标本的对照研究[J].中国矫形外科杂志,2005,13(8):598-601.

更新日期/Last Update: 2011-06-30