磁共振成像對前交叉韌帶損傷診斷價值的系統評價_《中國循證醫學雜志》

作者：

景天忠 ^1,2 , 田金徽 ¹ ,  楊克虎 ¹

1. 蘭州大學循證醫學中心，蘭州大學第一臨床醫學院（蘭州?730000）；2. 隴南市武都區第一人民醫院（隴南?746000）;

關鍵詞：

前交叉韌帶磁共振成像系統評價

DOI：

10.7507/1672-2531.20090099

視頻：

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目的　系統評價磁共振成像與關節鏡法成像相比診斷前交叉韌帶損傷的臨床價值。
方法　計算機檢索PubMed（1966～2008.8）、EMbase（1974～2008.8）、Cochrane圖書館（2008年第3期）、中國生物醫學文獻數據庫（1978～2008.8）、中國科技期刊全文數據庫（1994～2008.8）、中國期刊全文數據庫（1994～2008.8），并手工檢索相關期刊，全面收集磁共振成像診斷前交叉韌帶損傷的研究，按QUADAS條目評價納入研究質量，并對結果進行Meta分析。
結果　最終納入29個研究。結果顯示：磁共振成像與關節鏡相比，其敏感度、特異度、陽性似然比、陰性似然比以及SROC曲線下面積分別為：93%、93%、9.85、126.39和0.9714。
結論　磁共振成像可作為臨床上診斷前交叉韌帶損傷有效可行的方法。

引用本文： 景天忠,田金徽,楊克虎. 磁共振成像對前交叉韌帶損傷診斷價值的系統評價. 中國循證醫學雜志, 2009, 09(5): 536-541. doi: 10.7507/1672-2531.20090099 復制

1.	胥少汀, 葛寶豐, 徐印坎. 實用骨科學. 北京: 人民軍醫出版社, 2001. 714.
2.	Frank CB, Jackson DW. The sciences of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am, 1997, 79(10): 1556-1576.
3.	Arendt E, Dick R. Knee injury patterns among men and wemen in collegiate basketball and soccer: NCAA Data and review of literature.Am J Sports Med, 1995, 23(6): 694.
4.	De Marea M, Barbiera F, Lo Casto, et al. Biomechical correlations of lesions. Associated with traumatic disease of the anterior cruciate ligament:Analysis with magnetic resonance. Radiol Med Torino, 1996, 91(6): 693.
5.	Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athletic Training, 1999, 34(2): 86-92.
6.	Reicher MA, Hartzman S, Bassett LW, et al. MR Imaging of the knee joint Part: Tranmatic disorders. Radiology, 1987, 162(2): 547. 19.
7.	Schweitzer ME, Tran D, Deely DM, et al. Medial collateral ligament in juries: evaluation of multiple sign, prevalence and location of associated bone bruises, and assessment with MR imaging.Radiology, 1995,194(4): 825-829.
8.	Liehtinghagen R, Bahr M. Noninvasive diagnosis of fibrosis in chronic liver disease. Expert Re Mo1 Diagn, 2004, 4(51): 715-726.
9.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
10.	許建榮, 鄧霞, 華佳, 等. 前交叉韌帶不全撕裂的MRI診斷. 中國醫學計算機成像雜志, 2000, (6): 401-403.
11.	劉儉, 徐穎, 杜領娣, 等. 超聲、MRI及臨床穩定性試驗評價膝關節前交叉韌帶損傷比較. 中國醫學影像技術, 2001, 17(4): 337-338.
12.	周根泉, 張悅萍, 張貴祥, 等. 膝關節前交叉韌帶撕裂的MRI診斷. 中國醫學影像技術, 2002, (11): 1146-1150.
13.	孫水, 張偉, 王健. 前交叉韌帶損傷的MRI診斷與關節鏡下所見的比較研究. 醫學影像學雜志, 2003, 13(10): 764-766.
14.	高凱, 王立德, 齊志明, 等. 前交叉韌帶損傷的MRI診斷與臨床診斷比較研究. 中國運動醫學雜志, 2005, 24(5): 521-525.
15.	謝峰, 楊柳, 郭林, 等. 前交叉韌帶損傷MRI診斷價值與治療方案選擇的初步研究. 重慶醫學, 2006, 35(20): 1850-1852.
16.	孔德偉, 賈文霄, 張克遠, 等. 膝關節前交叉韌帶撕裂的MRI診斷及分析. 新疆醫科大學學報, 2006, 29(6): 536-538.
17.	Lee JK, Yao L, Phelps CT, et al. Anterior Cruciate Ligament Tears: MR Imaging Compared with Arthroscopy and Clinical Tests. Radiology, 1988, 166: 861-864.
18.	Boeree NR, Watkinson AF, Ackroyd CE, et al. Magnetic resonance imaging of meniscal and cruciate injuries of the knee. J Bone Joint Surg Br, 1991, 73: 452-457.
19.	Fischer SP, Fox JM, Del Pizzo W, et al. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am, 1991, 73: 2-10.
20.	Kelly MA, Flock TJ, Kimmel JA, et al. MR imaging of the knee: clarification of its role. Arthroscopy, 1991, 7: 78-85.
21.	Niitsu M, Anno I, Fukubayashi T, et al. Tears of cruciate ligaments and menisci:evaluation with cine MR imaging. Radiology, 1991, 178: 859-864.
22.	Gluckert K, Kladny B, Blank-Schal A, et al. MRI of the knee joint with a 3-Dgradient echo sequence: equivalent to diagnostic arthroscopy? Arch Orthop TraumaSurg, 1992, 112: 5-14.
23.	Grevitt MP, Pool CJ, Bodley RN, et al. Magnetic resonance imaging of the knee: initial experience in a district general hospital.Injury,1992, 23: 410-412.
24.	Heron CW, Calvert PT. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology, 1992, 183: 839-844.
25.	Barnett MJ. MR diagnosis of internal derangements of the knee:effect of field strength on efficacy. AJR Am J Roentgenol, 1993, 161: 115-118.
26.	Chan WP, Peterfy C, Fritz RC, et al. MR diagnosis of complete tears of the anterior cruciate ligament of the knee:importance of anterior subluxation of the tibia. AJR Am J Roentgenol, 1994, 62: 355-360.
27.	Gentili A, Seeger LL, Yao L, et al. Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology, 1994, 193: 835-840.
28.	Kinnunen J, Bondestam S, Kivioja A, et al. Diagnostic performance of low field MRI in acute knee injuries. Magn Reson Imaging, 1994, 12: 1155-1160.
29.	Chen MC, Shih TT, Jiang CC, et al. MRI of meniscus and cruciate ligament tears correlated with arthroscopy. J Formos Med Assoc, 1995, 94: 605-611.
30.	Lerman JE, Gray DS, Schweitzer ME, et al. MR evaluation of the anterior cruciate ligament: value of axial images. J Comput Assist Tomogr, 1995, 19: 604-607.
31.	Barry KP, Mesgarzadeh M, Triolo J, et al. Accuracy of MRI patterns in evaluating anterior cruciate ligament tears. Skeletal Radiol, 1996, 25: 365-370.
32.	Bui-Mansfield LT, Youngberg RA, Warme W, et al. Potential cost savings of MR imaging obtained before arthroscopy of the knee:evaluation of 50 consecutive patients. Am J Roentgenol, 1997, 168: 913-918.
33.	Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries:a double-blind comparison of 47 patients. Acta Orthop Scand, 1997, 68: 277-281.
34.	Ha TP, Li KC, Beaulieu CF, et al. Anterior cruciate ligament injury:fast spin-echo MR imaging with arthroscopic correlation in 217 examinations. Am J Roentgenol, 1998, 170: 1215-1219.
35.	Cotten A, Delfaut E, Demondion X, et al. MR imaging of the knee at 0.2 and 1.5 T:correlation with surgery. Am J Roentgenol, 2000, 174: 1093-1097.
36.	Chung HW, Kim YH, Hong SH, et al. Indirect signs of anterior cruciate ligament injury on SPET: Comparison with MRI an d arthroscopy. Nuclear Medicine Communications, 2000, 21: 651-658.
37.	Kocabey Y, Tetik O, Isbell WM, et al. The Value of Clinical Examination Versus Magnetic Resonance Imaging in the Diagnosis of Meniscal Tears and Anterior Cruciate Ligament Rupture. The Journal of Arthroscopic and Related, Surgery, 2004, 20(7): 696-700.
38.	Duc SR, Zanetti M, Kramer J, et al. Magnetic resonance imaging of ACL tears: evaluation of standard orthogonal and tailored paraconal images. Acta radiological, 2005, (7): 729-734.
39.	Patrick M, Bossuyt JB, Reitsma DE, et al. The STARD statement for reporting studies of diagnosis accuracy:explanation and elaboration.Croat Med J, 2003, 44: 639-650.

1. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學. 北京: 人民軍醫出版社, 2001. 714.
2. Frank CB, Jackson DW. The sciences of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am, 1997, 79(10): 1556-1576.
3. Arendt E, Dick R. Knee injury patterns among men and wemen in collegiate basketball and soccer: NCAA Data and review of literature.Am J Sports Med, 1995, 23(6): 694.
4. De Marea M, Barbiera F, Lo Casto, et al. Biomechical correlations of lesions. Associated with traumatic disease of the anterior cruciate ligament:Analysis with magnetic resonance. Radiol Med Torino, 1996, 91(6): 693.
5. Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athletic Training, 1999, 34(2): 86-92.
6. Reicher MA, Hartzman S, Bassett LW, et al. MR Imaging of the knee joint Part: Tranmatic disorders. Radiology, 1987, 162(2): 547. 19.
7. Schweitzer ME, Tran D, Deely DM, et al. Medial collateral ligament in juries: evaluation of multiple sign, prevalence and location of associated bone bruises, and assessment with MR imaging.Radiology, 1995,194(4): 825-829.
8. Liehtinghagen R, Bahr M. Noninvasive diagnosis of fibrosis in chronic liver disease. Expert Re Mo1 Diagn, 2004, 4(51): 715-726.
9. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
10. 許建榮, 鄧霞, 華佳, 等. 前交叉韌帶不全撕裂的MRI診斷. 中國醫學計算機成像雜志, 2000, (6): 401-403.
11. 劉儉, 徐穎, 杜領娣, 等. 超聲、MRI及臨床穩定性試驗評價膝關節前交叉韌帶損傷比較. 中國醫學影像技術, 2001, 17(4): 337-338.
12. 周根泉, 張悅萍, 張貴祥, 等. 膝關節前交叉韌帶撕裂的MRI診斷. 中國醫學影像技術, 2002, (11): 1146-1150.
13. 孫水, 張偉, 王健. 前交叉韌帶損傷的MRI診斷與關節鏡下所見的比較研究. 醫學影像學雜志, 2003, 13(10): 764-766.
14. 高凱, 王立德, 齊志明, 等. 前交叉韌帶損傷的MRI診斷與臨床診斷比較研究. 中國運動醫學雜志, 2005, 24(5): 521-525.
15. 謝峰, 楊柳, 郭林, 等. 前交叉韌帶損傷MRI診斷價值與治療方案選擇的初步研究. 重慶醫學, 2006, 35(20): 1850-1852.
16. 孔德偉, 賈文霄, 張克遠, 等. 膝關節前交叉韌帶撕裂的MRI診斷及分析. 新疆醫科大學學報, 2006, 29(6): 536-538.
17. Lee JK, Yao L, Phelps CT, et al. Anterior Cruciate Ligament Tears: MR Imaging Compared with Arthroscopy and Clinical Tests. Radiology, 1988, 166: 861-864.
18. Boeree NR, Watkinson AF, Ackroyd CE, et al. Magnetic resonance imaging of meniscal and cruciate injuries of the knee. J Bone Joint Surg Br, 1991, 73: 452-457.
19. Fischer SP, Fox JM, Del Pizzo W, et al. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am, 1991, 73: 2-10.
20. Kelly MA, Flock TJ, Kimmel JA, et al. MR imaging of the knee: clarification of its role. Arthroscopy, 1991, 7: 78-85.
21. Niitsu M, Anno I, Fukubayashi T, et al. Tears of cruciate ligaments and menisci:evaluation with cine MR imaging. Radiology, 1991, 178: 859-864.
22. Gluckert K, Kladny B, Blank-Schal A, et al. MRI of the knee joint with a 3-Dgradient echo sequence: equivalent to diagnostic arthroscopy? Arch Orthop TraumaSurg, 1992, 112: 5-14.
23. Grevitt MP, Pool CJ, Bodley RN, et al. Magnetic resonance imaging of the knee: initial experience in a district general hospital.Injury,1992, 23: 410-412.
24. Heron CW, Calvert PT. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology, 1992, 183: 839-844.
25. Barnett MJ. MR diagnosis of internal derangements of the knee:effect of field strength on efficacy. AJR Am J Roentgenol, 1993, 161: 115-118.
26. Chan WP, Peterfy C, Fritz RC, et al. MR diagnosis of complete tears of the anterior cruciate ligament of the knee:importance of anterior subluxation of the tibia. AJR Am J Roentgenol, 1994, 62: 355-360.
27. Gentili A, Seeger LL, Yao L, et al. Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology, 1994, 193: 835-840.
28. Kinnunen J, Bondestam S, Kivioja A, et al. Diagnostic performance of low field MRI in acute knee injuries. Magn Reson Imaging, 1994, 12: 1155-1160.
29. Chen MC, Shih TT, Jiang CC, et al. MRI of meniscus and cruciate ligament tears correlated with arthroscopy. J Formos Med Assoc, 1995, 94: 605-611.
30. Lerman JE, Gray DS, Schweitzer ME, et al. MR evaluation of the anterior cruciate ligament: value of axial images. J Comput Assist Tomogr, 1995, 19: 604-607.
31. Barry KP, Mesgarzadeh M, Triolo J, et al. Accuracy of MRI patterns in evaluating anterior cruciate ligament tears. Skeletal Radiol, 1996, 25: 365-370.
32. Bui-Mansfield LT, Youngberg RA, Warme W, et al. Potential cost savings of MR imaging obtained before arthroscopy of the knee:evaluation of 50 consecutive patients. Am J Roentgenol, 1997, 168: 913-918.
33. Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries:a double-blind comparison of 47 patients. Acta Orthop Scand, 1997, 68: 277-281.
34. Ha TP, Li KC, Beaulieu CF, et al. Anterior cruciate ligament injury:fast spin-echo MR imaging with arthroscopic correlation in 217 examinations. Am J Roentgenol, 1998, 170: 1215-1219.
35. Cotten A, Delfaut E, Demondion X, et al. MR imaging of the knee at 0.2 and 1.5 T:correlation with surgery. Am J Roentgenol, 2000, 174: 1093-1097.
36. Chung HW, Kim YH, Hong SH, et al. Indirect signs of anterior cruciate ligament injury on SPET: Comparison with MRI an d arthroscopy. Nuclear Medicine Communications, 2000, 21: 651-658.
37. Kocabey Y, Tetik O, Isbell WM, et al. The Value of Clinical Examination Versus Magnetic Resonance Imaging in the Diagnosis of Meniscal Tears and Anterior Cruciate Ligament Rupture. The Journal of Arthroscopic and Related, Surgery, 2004, 20(7): 696-700.
38. Duc SR, Zanetti M, Kramer J, et al. Magnetic resonance imaging of ACL tears: evaluation of standard orthogonal and tailored paraconal images. Acta radiological, 2005, (7): 729-734.
39. Patrick M, Bossuyt JB, Reitsma DE, et al. The STARD statement for reporting studies of diagnosis accuracy:explanation and elaboration.Croat Med J, 2003, 44: 639-650.

《中國循證醫學雜志》

磁共振成像對前交叉韌帶損傷診斷價值的系統評價

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《中國循證醫學雜志》

磁共振成像對前交叉韌帶損傷診斷價值的系統評價

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