CT与MRI在不同分期膝半月板和关节软骨损伤患者中的诊断对比
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摘要
目的探讨CT与MRI在不同分期膝半月板和关节软骨损伤患者中的诊断对比。方法选取2016年1月至2018年5月我院收治的膝半月板及关节软骨损伤患者共68例作为研究对象,全部患者均行CT与MRI检查,以膝关节镜为诊断金标准,比较CT与MRI诊断结果的准确性。结果膝半月板损伤MRI检出率为93.85%,显著优于CT检出率81.53%,I级、II级诊断准确率比较差异无统计学意义(P>0.05),III期诊断中MRI诊断准确率显著优于CT(P<0.05);关节软骨检查中MRI检出率为96.61%,显著优于CT检出率83.05%,I期、IIa期、IIb期、III期诊断准确率对比无统计学差异(P>0.05),IV期诊断中MRI诊断率为91.67%,显著优于CT诊断率75%(P<0.05)。结论 MR诊断IV期关节软骨损伤与III级半月板损伤准确率显著优于CT,MR与CT在其余膝半月板与关节软骨损伤分级上均具有较高准确性。
Objective To investigate the diagnostic value of CT and MRI in patients with different stages of knee meniscus and articular cartilage injury.Methods A total of68 patients with knee meniscus and articular cartilage injury treated in our hospital from January 2016 to May 2018 were selected and underwent CT and MRI examination.The examination results were compared with those of knee arthroscopy as golden standard.Then the diagnostic accuracy of CT and MRI was compared.Results The diagnosis rate of knee meniscus was 93.85%for MRI and 81.35%for CT.The diagnosis accuracy rate in grade I and grade II had no difference(P>0.05),while the diagnosis accuracy rate in stage III of the MRI was higher than that of the CT(P<0.05).The diagnostic rate of articular cartilage injury was 96.61%for MRI and 83.05%for CT.The diagnostic accuracy among the stage of I,IIa,IIb and III had no difference(P>0.05).The diagnostic rate for stage IV of MRI was significantly higher than that of CT(91.67%vs75%,P<0.05).Conclusion The diagnostic accuracy rate for knee meniscus and III articular cartilage injury of MRI was higher than that of the CT,and the diagnosis rate of two examinations is similar for the rest types.
Objective To investigate the diagnostic value of CT and MRI in patients with different stages of knee meniscus and articular cartilage injury.Methods A total of68 patients with knee meniscus and articular cartilage injury treated in our hospital from January 2016 to May 2018 were selected and underwent CT and MRI examination.The examination results were compared with those of knee arthroscopy as golden standard.Then the diagnostic accuracy of CT and MRI was compared.Results The diagnosis rate of knee meniscus was 93.85%for MRI and 81.35%for CT.The diagnosis accuracy rate in grade I and grade II had no difference(P>0.05),while the diagnosis accuracy rate in stage III of the MRI was higher than that of the CT(P<0.05).The diagnostic rate of articular cartilage injury was 96.61%for MRI and 83.05%for CT.The diagnostic accuracy among the stage of I,IIa,IIb and III had no difference(P>0.05).The diagnostic rate for stage IV of MRI was significantly higher than that of CT(91.67%vs75%,P<0.05).Conclusion The diagnostic accuracy rate for knee meniscus and III articular cartilage injury of MRI was higher than that of the CT,and the diagnosis rate of two examinations is similar for the rest types.
引文
[1]吴迎春,孙辉,依力潘·凯赛尔.膝半月板和关节软骨损伤的影像学表现[J].中国地方病防治杂志,2017(3):347-348.
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[3]陈新国,王兴华,刘丽,等.MRI和多层螺旋CT诊断膝关节损伤临床价值分析[J].医学影像学杂志,2017,27(12):2388-2391.
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[6]李强,赵宝力,郭艾,等.膝关节半月板损伤膝关节半月板损伤MRI临床价值的对比研究[C]//北京关节镜外科学术年会.2010.
[7]邹积泉肖永忠.膝关节半月板损伤MRI诊断与关节镜对比研究[J].罕少疾病杂志,2015,21(4):42-44.
[8]郑继坤,毛晓雯,李国晖,等.半月板退变和损伤与滋养血管的MRI鉴别研究[J].中国CT和MRI杂志,2014,(6):91-94.
[9]刘军,刘欢,王发祥.MSCT与MRI在胫骨平台隐匿性骨折中的诊断价值[J].中国骨与关节损伤杂志,2017,(2):210-211.
[10]Cucchiarini M,Mcnulty A L,Mauck R L,et al.Advances in combining gene therapy with cell and tissue engineering-based approaches to enhance healing of the meniscus.[J].Osteoarthritis&Cartilage,2016,24(8):1330-1339.
[11]Emmanuel K,Quinn E,Niu J,et al.Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis--data from the Osteoarthritis Initiative[J].Osteoarthritis&Cartilage,2016,24(2):262-269.
[12]Iijima H,Aoyama T,Tajino J,et al.Subchondral plate porosity colocalizes with the point of mechanical load during ambulation in a rat knee model of post-traumatic osteoarthritis[J].Osteoarthritis&Cartilage,2016,24(2):354-363.
[13]刘卉荣,王志芳,马蕾,等.X线、CT、MRI三种技术诊断退行性膝关节炎的临床价值[J].医学影像学杂志,2016,26(8):1549-1552.
[14]Haviv B,Bronak S,Kosashvili Y,et al.Which patients are less likely to improve during the first year after arthroscopic partial meniscectomy?A multivariate analysis of 201 patients with prospective follow-up[J].Knee Surgery Sports Traumatology Arthrosc opy,2016,24(5):1427-1431.
[15]Felson D T,Niu J,Neogi T,et al.Synovitis and the risk of knee osteoarthritis:the most study[J].Osteoarthritis&Cartilage,2016,24(3):458-464.
[16]马蔚,李玉智.MRI检查膝关节半月板桶柄样撕裂的临床价值分析[J].医学影像学杂志,2016,26(7):1348-1350.
[17]高志国,肖彬,李小依,等.磁共振GRE-T2*序列对膝关节半月板撕裂的诊断价值[J].中国CT和MRI杂志,2015,13(12):110-112.
[2]Sihvonen R,Englund M,Turkiewicz A,et al.Mechanical Symptoms as an Indication for Knee Arthroscopy in Patients with Degenerative Meniscus Tear:A Prospective Cohort Study.[J].Osteoarthritis&Cartilage,2016,24(8):1367-1375.
[3]陈新国,王兴华,刘丽,等.MRI和多层螺旋CT诊断膝关节损伤临床价值分析[J].医学影像学杂志,2017,27(12):2388-2391.
[4]Eitzen I,Grindem H,Nilstad A,et al.Quantifying Quadriceps Muscle Strength in Patients With ACLInjury,Focal Cartilage Lesions,and Degenerative Meniscus Tears[J].Orthopaedic Journal of Sports Medicine,4,10(2016-10-11),2016,4(10).
[5]张强军,赵栓来.核磁共振诊断膝关节半月板损伤的可行性研究[J].中国医学装备,2016,13(5):61-63.
[6]李强,赵宝力,郭艾,等.膝关节半月板损伤膝关节半月板损伤MRI临床价值的对比研究[C]//北京关节镜外科学术年会.2010.
[7]邹积泉肖永忠.膝关节半月板损伤MRI诊断与关节镜对比研究[J].罕少疾病杂志,2015,21(4):42-44.
[8]郑继坤,毛晓雯,李国晖,等.半月板退变和损伤与滋养血管的MRI鉴别研究[J].中国CT和MRI杂志,2014,(6):91-94.
[9]刘军,刘欢,王发祥.MSCT与MRI在胫骨平台隐匿性骨折中的诊断价值[J].中国骨与关节损伤杂志,2017,(2):210-211.
[10]Cucchiarini M,Mcnulty A L,Mauck R L,et al.Advances in combining gene therapy with cell and tissue engineering-based approaches to enhance healing of the meniscus.[J].Osteoarthritis&Cartilage,2016,24(8):1330-1339.
[11]Emmanuel K,Quinn E,Niu J,et al.Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis--data from the Osteoarthritis Initiative[J].Osteoarthritis&Cartilage,2016,24(2):262-269.
[12]Iijima H,Aoyama T,Tajino J,et al.Subchondral plate porosity colocalizes with the point of mechanical load during ambulation in a rat knee model of post-traumatic osteoarthritis[J].Osteoarthritis&Cartilage,2016,24(2):354-363.
[13]刘卉荣,王志芳,马蕾,等.X线、CT、MRI三种技术诊断退行性膝关节炎的临床价值[J].医学影像学杂志,2016,26(8):1549-1552.
[14]Haviv B,Bronak S,Kosashvili Y,et al.Which patients are less likely to improve during the first year after arthroscopic partial meniscectomy?A multivariate analysis of 201 patients with prospective follow-up[J].Knee Surgery Sports Traumatology Arthrosc opy,2016,24(5):1427-1431.
[15]Felson D T,Niu J,Neogi T,et al.Synovitis and the risk of knee osteoarthritis:the most study[J].Osteoarthritis&Cartilage,2016,24(3):458-464.
[16]马蔚,李玉智.MRI检查膝关节半月板桶柄样撕裂的临床价值分析[J].医学影像学杂志,2016,26(7):1348-1350.
[17]高志国,肖彬,李小依,等.磁共振GRE-T2*序列对膝关节半月板撕裂的诊断价值[J].中国CT和MRI杂志,2015,13(12):110-112.