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目的:探讨形态学指标在成人完全型外侧盘状半月板损伤MRI评价中的价值。方法:回顾性分析具有完整术前MRI影像资料并经关节镜手术证实的成人完全型外侧盘状半月板病例68例(70膝)。由一名放射学住院医师(甲)和一名运动医学主任医师(乙)采用双盲法独立分析所有病例MRI图像资料。采用楔形征、板形征、游离缘肥厚征和肥角征等4个形态学指标作为评价外侧盘状半月板形态学特征的指标。以膝关节镜作为诊断金标准,探讨上述4个形态学指标评价成人完全型外侧盘状半月板损伤的能力。采用Kappa检验评价2名医师诊断结果的一致性。结果:Kappa评价显示2名医师评价结果的一致性极佳(K值>0.75,P<0.001)。外侧盘状半月板损伤组中游离缘肥厚征和肥角征的发生率明显高于无损伤组(P<0.05);无损伤组楔形征的发生率明显高于损伤组(P<0.05)。两组板形征的发生率间比较差异无统计学意义(P>0.05)。楔形征病例中外侧盘状半月板损伤的发生率为14.8%(甲)和12.0%(乙),板形征为33.3%(甲)和37.5%(乙),游离缘肥厚征为94.1%(甲)和100%(乙),肥角征甲、乙均为100%。与楔形征比较,游离缘肥厚征和肥角征预示存在外侧盘状半月板损伤的风险更高(P<0.001)。而板形征与楔形征间比较差异无统计学意义。结论:损伤与无损伤的成人完全型外侧盘状半月板的MRI形态学特征有所不同。形态学指标对于评价成人完全型外侧盘状半月板损伤具有一定价值。
Objective: To investigate the value of morphological parameters in MRI evaluation of adult complete discoid meniscus injury. Methods: A total of 68 adult patients with complete discoid meniscus (70 knees) with complete preoperative MRI data and confirmed by arthroscopic surgery were retrospectively analyzed. A radiological resident (A) and a sports medicine chief physician (B) independently analyzed MRI data of all cases by double-blind method. Four morphological indexes such as wedge sign, plate sign, free edge hypertrophy sign and fat corner sign were used as indexes to evaluate the morphological characteristics of the lateral discoid meniscus. With knee arthroscopy as the gold standard of diagnosis, the above four morphological indexes were evaluated to evaluate the ability of adult complete discoid meniscus injury. Kappa test was used to evaluate the consistency of the results of two doctors. Results: Kappa evaluation showed excellent agreement between two physicians (K value> 0.75, P <0.001). The incidence of free edge hypertrophy and fat corner syndrome in the lateral discoid meniscus injury group was significantly higher than that in the non-injury group (P <0.05). The incidence of wedge sign in the non-injury group was significantly higher than that in the injury group (P <0.05). There was no significant difference between the two groups (P> 0.05). The incidence of lateral discoid meniscus injury was 14.8% (A) and 12.0% (B) in wedge-shaped cases, 33.3% (A) and 37.5% (B) in plate shape, and 94.1% in free-edge hypertrophy A) and 100% (B), fat corner of a, B are 100%. Compared with the wedge-shaped sign, the free edge hypertrophy and the fat sign indicate that there is a higher risk of lateral discoid meniscus injury (P <0.001). There was no significant difference between plate shape and wedge shape. CONCLUSIONS: MRI morphological characteristics of adult complete discoid meniscus with or without injury are different. Morphological indicators for the evaluation of adult complete lateral discoid meniscus injury has a certain value.