简体中文

论著-头颈部

膝关节半月板损伤 的影像学诊断研究

作者:李奎生

所属单位:福建省漳州市中医院放射科 (福建 漳州 363000)

PDF

摘要

目的 对比CT与MRI在诊断膝关节 半月板损伤中的应用。方法 回顾性分析 高度疑似膝关节半月板损伤患者41例临床 资料,均行CT和MRI诊断,对比诊断结果 及影像学表现,并与关节镜检查对照。结 果 以关节镜检查为“金标准”,MRI诊断 半月板损伤的准确率、敏感性、特异性分 别为97.56%、97.01%、100%,显著高于CT 的79.27%、82.09%、66.67%(P<0.05)。CT 表现为半月板形态改变,明显增大,边缘 粗糙;半月板内有低密度影;撕裂半月板 出现移位;部分存在关节腔积液和多发性 泡状充气征。Ⅰ级损伤MRI的T2WI上可见 半月板内有高信号影,Ⅱ级损伤在T2WI上 可见水平、垂直高信号影,Ⅲ级在T2WI上 为高信号影,且延续至关节面边缘。结论 MRI诊断临床诊断膝关节半月板损伤的准 确率高于CT,且能显示半月板的部位、形 态改变。

Objective To compare the application of CT and MRI in the diagnosis of jmeniscus injury of knee jointoint meniscus injury. Methods The clinical data of 41 cases of patients with suspected meniscus injury of knee joint were analyzed retrospectively. Both of CT and MRI diagnosis were performed. The diagnostic results and imaging findings were compared and were with arthroscopy. Results Arthroscopy was taken as the golden standard and the accuracy, sensitivity and specificity of MRI in diagnosis of meniscus injury were 97.56%, 97.01% and 100%, respectively which were significantly higher than those of CT (79.27%, 82.09%, 66.67%). CT showed that the shape of meniscus changed, and was obviously enlarged and the edge was rough. There was low density shadow in meniscus; Tear meniscus shifted. There were liquid aggregation of joint cavity and multiple bubble inflation signs in some parts. On T2, MRI of grade I injury showed high signal shadow in the meniscus. Grade Ⅱinjury showed horizontal and vertical high signal shadow on T2. Grade Ⅲ showed high signal shadow on T2 and extends to the edge of the articular surface. Conclusion The accuracy rate of MRI in the diagnosis of meniscus injury of knee joint is higher than that of CT, and it can show the location and changes of shape of the meniscus

【关键词】半月板损伤;膝关节;核磁共 振;CT;形态

【中图分类号】R641;R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.09.038

前言

半月板损伤是膝关节损伤的常见类型,若治疗不当,易引发膝关 节紊乱。关节镜是临床检查膝关节半月板损伤的“金标准”,能够 确定半月板的形态、受损程度,但属于有创检查,限制了其临床应 用[1]。CT、MRI是临床诊断半月板损伤的常用影像学方式,其中CT能够 完整显示半月板的位置,但在疾病分级中还存在局限性。MRI能够准确 反映半月板撕裂的位置、撕裂类型、半月板形态等,是临床诊断膝关 节半月板损伤的首选影像学方式。对此,本文分析了41例高度疑似膝 关节半月板损伤患者的影像学资料,并将检查结果与关节镜对照,现 报道如下。