金笑,王亚魁,郎宁,袁慧书.30°屈曲位膝关节MRI评价前交叉韧带断裂的价值[J].中国医学影像技术,2019,35(5):754~758
30°屈曲位膝关节MRI评价前交叉韧带断裂的价值
Value of 30° flexed knee MRI in evaluating anterior cruciate ligament tears
投稿时间:2018-11-05  修订日期:2019-03-05
DOI:10.13929/j.1003-3289.201811027
中文关键词:  前交叉韧带  膝关节  磁共振成像
英文关键词:anterior cruciate ligament  knee joint  magnetic resonance imaging
基金项目:
作者单位E-mail
金笑 北京大学第三医院放射科, 北京 100191  
王亚魁 北京大学第三医院放射科, 北京 100191  
郎宁 北京大学第三医院放射科, 北京 100191  
袁慧书 北京大学第三医院放射科, 北京 100191 huishuy@bjmu.edu.cn 
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中文摘要:
      目的 探讨30°屈曲体位膝关节MRI对显示前交叉韧带(ACL)和评价ACL断裂的应用价值。方法 选取64例接受膝关节镜检查的膝关节外伤患者,依次行微屈位(约17°)及30°屈曲位膝关节MRI,由2名医师分别对ACL全长、双束结构、断裂ACL的断裂点及残端状况显示进行评分,并以关节镜结果为金标准,计算诊断ACL断裂的敏感度、特异度和准确率。结果 微屈位MRI诊断ACL断裂的敏感度、特异度和准确率分别为97.44%(38/39)、100%(25/25)和98.44%(63/64),30°屈曲位MRI均为100%,二者诊断ACL断裂的一致性好(Kappa=0.967)。30°屈曲位扫描对ACL全长、断裂点及残端的显示优于微屈位(P均<0.001),二者对ACL双束结构的显示差异无统计学意义(P=0.223)。结论 30°屈曲位与微屈位MR扫描诊断ACL断裂的敏感度、特异度及准确率均较高,30°屈曲位显示ACL全长及其断裂情况优于微屈位。
英文摘要:
      Objective To investigate the value of 30° flexed knee MRI in evaluating anterior cruciate ligament (ACL) tears. Methods Totally 64 knee trauma patients who underwent arthroscopy were included. Knee MRI in slightly flexed (about 17°) and 30° flexed positions were successively performed in all patients. The delineation of ACL full length, double-bundle structure and torn ACL's disrupted sites combined with ligament remnants were rated separately by 2 radiologists. Taken arthroscopy results as golden standards, the sensitivity, specificity and accuracy were calculated. Results The diagnosing sensitivity, specificity and accuracy of ACL tears were 97.44% (38/39), 100% (25/25) and 98.44% (63/64) respectively in slightly flexed knee MRI, while they were all 100% in 30° flexed knee MRI. There was good consistency between the two positions (Kappa=0.967). MRI of 30° flexion was superior to slightly flexion in delineation of ACL full length and torn ACL's disrupted sites combined with ligament remnants (both P<0.001), while no statistical difference was found in the delineation of ACL double-bundle structure (P=0.223). Conclusion Both slightly flexed and 30° flexed knee MRI have high sensitivity, specificity and accuracy in diagnosing ACL tears, whereas 30° flexion MRI is superior to slightly flexion images in delineation of ACL and its tears.
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