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膝关节盘状外侧半月板的磁共振成像诊断

Diagnosis of discoid lateral meniscus of the knee on MR imaging.

作者信息

Samoto Nobuhiko, Kozuma Masakazu, Tokuhisa Toshio, Kobayashi Kunio

机构信息

Department of Orthopaedic Surgery, Fukuoka Red Cross Hospital, 3-1-1 Okusu, Minami-Ku, Fukuoka 815-0082, Japan.

出版信息

Magn Reson Imaging. 2002 Jan;20(1):59-64. doi: 10.1016/s0730-725x(02)00473-3.

Abstract

To establish the quantitative MR diagnostic criteria for discoid lateral meniscus, MR imaging of 60 knees with arthroscopically confirmed discoid lateral menisci and 134 knees with semilunar lateral menisci were analyzed. Following four quantitative parameters were measured. (1) Meniscal width (MW): The minimum meniscal width on the coronal slice. (2) Ratio of the meniscus to the tibia (RMT): The ratio of minimum meniscal width to maximum tibial width on the coronal slice. (3) Percent coverage of the meniscus (PCM): The ratio of the sum of the width of the anterior and posterior horns to the meniscal diameter on the sagittal slice showing the maximum meniscal diameter. (4) Continuity of the anterior and posterior horns (CAPH): The number of consecutive sagittal slices showing continuity between the anterior and posterior horns of the meniscus on the sagittal slice. The cut-off values of each parameter to discriminate between the discoid and semilunar meniscus were calculated based on a univariate logistic regression analysis. The sensitivity and specificity were also calculated for each of 4 parameters and combinations of these parameters. The cut-off value was 15 mm for the MW, 20% for the RMT, 75% for the PCM, and 3 slices for the CAPH. The sensitivity and specificity of the four parameters ranged between 87% and 50% and between 99% and 92%, respectively. The most accurate diagnostic criterion was either the RMT > or = 20% or the PCM > or = 75%, and the sensitivity and specificity were 95% and 97%, respectively, even when torn menisci were included.

摘要

为确立盘状外侧半月板的定量磁共振(MR)诊断标准,对60例经关节镜证实为盘状外侧半月板的膝关节以及134例外侧半月板为半月形的膝关节进行了MR成像分析。测量了以下四个定量参数。(1)半月板宽度(MW):冠状面上半月板的最小宽度。(2)半月板与胫骨比值(RMT):冠状面上半月板最小宽度与胫骨最大宽度的比值。(3)半月板覆盖百分比(PCM):在显示半月板最大直径的矢状面上,前后角宽度之和与半月板直径的比值。(4)前后角连续性(CAPH):在矢状面上显示半月板前后角连续性的连续矢状面切片数量。基于单变量逻辑回归分析计算每个参数区分盘状半月板和半月形半月板的临界值。还计算了4个参数及其组合中每个参数的敏感性和特异性。MW的临界值为15mm,RMT为20%,PCM为75%,CAPH为3个切片。四个参数的敏感性和特异性分别在87%至50%以及99%至92%之间。最准确的诊断标准是RMT≥20%或PCM≥75%,即使包括半月板撕裂的情况在内,其敏感性和特异性分别为95%和97%。

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