MRI与诊断性膝关节关节镜评估半月板撕裂

H. Ali, Mohamed Yehya
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摘要

本研究比较了MRI和膝关节诊断性关节镜检查的结果来评估半月板撕裂。患者和方法本研究选择了2018年3月至2020年5月期间接受膝关节MRI检查的32例患者,并进行了关节镜检查。所有的膝盖都被检查是否有半月板撕裂。将MRI结果与关节镜检查结果进行比较。关节镜结果作为金标准来识别是否存在半月板撕裂。32例患者中,男性24例,女性8例。平均年龄31岁(22 ~ 45岁)。有盘状外侧半月板、半月板手术史或受伤膝盖手术史的患者被排除在研究之外。敏感性、特异性和准确性是根据关节镜检查结果计算的。结果MRI与关节镜检查间隔7 ~ 10周,平均8周。在某些情况下,MRI和关节镜检查结果显示半月板撕裂存在差异。MRI假阳性1例(3.1%),假阴性5例(15.6%)。MRI评估半月板撕裂的准确率为90.58%。结论MRI是一种无创且异常灵敏的检查方法,可以发现半月板内的早期和轻微异常。然而,MRI并不是100%准确;如果MRI结果为阴性,但患者持续抱怨症状,则应考虑关节镜检查。
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MRI versus diagnostic arthroscopy of the knee to evaluate meniscal tears
Background This study compares between the results of MRI and diagnostic arthroscopy of the knee to evaluate meniscal tears. Patients and methods A total of 32 patients who had undergone MRI of the knee between March 2018 and May 2020 were selected for the study in whom arthroscopy had also been performed. All knees had been investigated for possible meniscal tears. The MRI results were compared with those of arthroscopy. The arthroscopic results were used as the gold standard to recognize if meniscal tear is present or not. Of the 32 patients, 24 were males and eight were females. The average age was 31 years (range, 22–45 years). Patients who had a discoid lateral meniscus, history of meniscal surgery, or prior surgery on the injured knee were excluded from the study. The sensitivity, specificity, and accuracy were calculated based on arthroscopic findings. Results The time between MRI and arthroscopy was 7–10 weeks (average, 8 weeks). In certain cases, a difference was noted between the MRI and arthroscopic findings for revealing the meniscal tears. False-positive MRI result was found in one (3.1%) patient and false-negative MRI result was found in five (15.6%) patients. The accuracy of MRI in the evaluation of meniscal tears was 90.58%. Conclusions MRI is a noninvasive and exceptionally a sensitive method of investigation that may detect early and slight abnormalities within the menisci. However, MRI is not 100% accurate; if MRI result is reported as negative but the patient keeps complaining of continuing symptoms, then arthroscopy should be considered.
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