膝關節半月板撕裂的低場MRI及關節鏡表現評估_《華西醫學》

作者：

黃文光 ^1,2 , 陳海燕 ¹

【作者單位】1 四川大學華西醫院放射科（成都，610041）;2 廣元市第一人民醫院CT、MRI室;

關鍵詞：

半月板撕裂 MRI 關節鏡檢查

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【摘要】　目的　評價低場MRI對膝關節半月板撕裂的診斷準確性。　方法　 2009年9月-2010年4月經關節鏡檢或手術確診的膝關節損傷患者69例，其中35例41個半月板撕裂，回顧性分析、整理其臨床、關節鏡及MRI表現，以傳統Reicher診斷的改良分級標準確定半月板撕裂的級別、形態并記錄，同時對關節內其它伴隨征象作統計。　結果　 35例41個撕裂半月板中，17個為盤狀半月板，MRI顯示Ⅲa級撕裂信號24個，Ⅲb級撕裂信號5個，Ⅲc級撕裂信號4個，Ⅳ級撕裂信號1個，桶柄狀撕裂信號7個。本組低場MRI診斷半月板撕裂的敏感度、特異度、準確度分別為93.18%、92.11%、92.68%。　結論　低場MRI診斷膝關節半月板撕裂與關節鏡結果差異不大，是一種診斷半月板撕裂的可靠、無創性檢查方法。
【Abstract】　Objective　 To evaluate the accuracy of low-field MRI in the diagnosis of meniscus tears.　Methods　 We collected the clinical data of 69 patients with knee joint injuries confirmed by surgical operation or arthroscopy from Septembe 2009 to April 2010. Among them, 35 patients had 41 cases of meniscus tears. We retrospectively analyzed their clinical symptoms, and their manifestations on low-field MRI and arthroscopy. According to the modified diagnostic criteria based on Reicher’s diagnosis, the grade and the shape of meniscus tears were determined and recorded, and other accompanying signs inside the joint were also analyzed statistically.　Results　 Among the 41 cases of meniscus tears of 35 patients, 17 were discoid meniscus. MRI showed that there were 24 signals of Ⅲa tears, 5 of Ⅲb tears, 4 of Ⅲc tears, 1 of Ⅳ tears and 7 of bucket-handle tears. The sensitivity, specificity and accuracy of low-field MRI in the diagnosis of meniscus tears were 93.18%, 92.11%, and 92.68%, respectively.　Conclusions　 There is no significant difference between the results of arthroscopy and low-field MRI in diagnosing meniscus tears. Consequently, MRI is a reliable and non-invasive method in the diagnosis of meniscus tears.

引用本文： 黃文光,陳海燕. 膝關節半月板撕裂的低場MRI及關節鏡表現評估. 華西醫學, 2011, 26(2): 222-225. doi: 復制

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8.	Wright DH, de Smet AA, Norris M. Bucket, handle tears of medical and lateral menisci of the knee:value of MR imaging in detecting displaced fragments[J]. AJR, 1995, 165(3): 621-625.
9.	趙明增, 張華文, 楊少鋒. 低場強磁共振梯度回波和脂肪抑制成像在膝關節外傷中的診斷價值[J].現代醫用影像學, 2005, 4(4): 60-63.
10.	錢家新.膝關節外傷的低場MRI診斷[J]. 實用醫學影像雜志, 2007, 8(1): 29-30, 42.
11.	Kersting-sommerhoff B, Cerdhart P, Golder W, et al. MRI of the knee joint: fiest results of a 0.2T dedicated system with a 1.5T high field system[J]. Clinical MRI, 1996, 6: 15-24.
12.	袁維軍, 石士奎, 張曉智. 低場MRI與關節鏡對膝關節半月板損傷診斷價值的對比觀察[J].中國介入影像與治療學, 2009, 6(3): 271-273.
13.	Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries: a double-blind comparison of 47 patients[J]. Acta Orthop Scand, 1997, 68(3): 277-281.

1. 　Carmichael IW, MacLeod AM, Travlos J. MRI can prevent unnecessary arthroscopy[J].J Bone Jt Surg Br ,1997, 79(4): 624-625.
2. 　Trieshmann HW, Mosure JC. The impact of magnetic resonance imaging of the knee on surgical decision making[J]. Arthroscopy, 1996, 12(5): 550-555.
3. 　Ruff C, Weingardt JP, Russ PD, et al. MR imaging patterns of displaced meniscus injuries of the knee[J]. AJR, 1998, 17(1): 63-67.
4. 　王仁貴, 高玉潔, 蔣學祥, 等. 膝關節半月板損傷的MRI診斷[J]. 中華放射學雜志, 1997, 31(7): 02-459.
5. 　郭啟勇. 磁共振成像鑒別診斷學[M]. 沈陽: 遼寧科學技術出版社, 2007: 391-394.
6. 　周根權, 沈天真, 陳星榮, 等. 膝關節半月板撕裂的MRI(與手術、關節鏡對照研究)[J]. 中國醫學計算機成像雜志, 1998, 4(3): 181-184.
7. 　李崢艷, 鄒翎, 李箭, 等. 膝關節半月板桶柄狀撕裂低場強MRI分析[J]. 四川大學學報（醫學版）, 2009, 40(4): 749-751.
8. 　Wright DH, de Smet AA, Norris M. Bucket, handle tears of medical and lateral menisci of the knee:value of MR imaging in detecting displaced fragments[J]. AJR, 1995, 165(3): 621-625.
9. 　趙明增, 張華文, 楊少鋒. 低場強磁共振梯度回波和脂肪抑制成像在膝關節外傷中的診斷價值[J].現代醫用影像學, 2005, 4(4): 60-63.
10. 　錢家新.膝關節外傷的低場MRI診斷[J]. 實用醫學影像雜志, 2007, 8(1): 29-30, 42.
11. 　Kersting-sommerhoff B, Cerdhart P, Golder W, et al. MRI of the knee joint: fiest results of a 0.2T dedicated system with a 1.5T high field system[J]. Clinical MRI, 1996, 6: 15-24.
12. 　袁維軍, 石士奎, 張曉智. 低場MRI與關節鏡對膝關節半月板損傷診斷價值的對比觀察[J].中國介入影像與治療學, 2009, 6(3): 271-273.
13. 　Rappeport ED, Wieslander SB, Stephensen S, et al. MRI preferable to diagnostic arthroscopy in knee joint injuries: a double-blind comparison of 47 patients[J]. Acta Orthop Scand, 1997, 68(3): 277-281.

《華西醫學》

膝關節半月板撕裂的低場MRI及關節鏡表現評估

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《華西醫學》

膝關節半月板撕裂的低場MRI及關節鏡表現評估

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