Lee G, Hooker M, Harpstrite K
Department of Orthopedics, Tripler Army Medical Center, 1 Jarret White Road, Honolulu, HI 96859-5000, USA.
Mil Med. 2001 Feb;166(2):126-31.
A prospective study was conducted to evaluate the use of magnetic resonance imaging (MRI) by orthopedic surgeons and residents versus the use of MRI by non-orthopedically trained health care providers in diagnosing knee pathology. Fifty patients initially evaluated by members of one of these groups who underwent subsequent knee MRI evaluation were selected to participate. Two orthopedic examiners individually examined all patients, recording clinical diagnosis and the merit of MRI evaluation in each case. Clinical accuracy, sensitivity, and specificity were compared between groups based on MRI findings. Diagnostic accuracy was similar; however, the orthopedic group displayed greater sensitivity, suggesting better clinical assessment. The study examiners observed both groups using MRI equally inappropriately and found 62% of the imaging studies unjustified. We conclude that knee MRI is used inappropriately in the current military setting. An algorithm is proposed to guide the future use of MRI in the diagnosis and management of knee pathology.
开展了一项前瞻性研究，以评估骨科外科医生和住院医师使用磁共振成像（MRI）与未接受骨科培训的医疗保健提供者使用MRI诊断膝关节病变的情况。从这些组中的一组成员最初评估并随后接受膝关节MRI评估的50名患者中选取参与研究。两名骨科检查人员分别对所有患者进行检查，记录每个病例的临床诊断和MRI评估的价值。根据MRI结果比较两组之间的临床准确性、敏感性和特异性。诊断准确性相似；然而，骨科组显示出更高的敏感性，表明临床评估更好。研究检查人员观察到两组使用MRI的情况同样不当，发现62%的影像学检查不合理。我们得出结论，在当前军事环境中，膝关节MRI的使用不当。提出了一种算法，以指导未来MRI在膝关节病变诊断和管理中的使用。
