Jee Won-Hee, McCauley Thomas R, Kim Jung-Man, Jun Dong-Jin, Lee Young-Joon, Choi Byung-Gil, Choi Kyu-Ho
Department of Diagnostic Radiology, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-701 Seoul, Korea.
AJR Am J Roentgenol. 2003 Jan;180(1):93-7. doi: 10.2214/ajr.180.1.1800093.
The purpose of this study was to evaluate the accuracy of MR imaging for categorizing the configuration of meniscal tears of the knee.
Fast spin-echo MR images obtained at 1.5 T from 110 patients who had meniscal tears identified at arthroscopy were retrospectively and independently classified by two reviewers into five configurations: horizontal, longitudinal, radial, oblique, and complex. MR imaging categorization was compared with arthroscopic results as the standard of reference. Data were also analyzed with longitudinal and oblique tears combined because these usually are reparable, and with horizontal, radial, and complex tears combined because these usually are not reparable. Interobserver and intraobserver agreements were calculated using kappa coefficients.
At arthroscopy, meniscal tears were categorized as horizontal (n = 44), longitudinal (n = 34), complex (n = 22), radial (n = 11), and oblique (n = 5). Sensitivity, specificity, and accuracy of each reviewer for the reparable tears were 82%, 92%, and 89%; and 59%, 97%, and 84%, respectively. Interobserver agreements were fair between reviewer 1 and the first and second interpretations of reviewer 2 (kappa = 0.25, p < 0.005; and kappa = 0.21, p < 0.05, respectively). Intraobserver agreement was substantial (kappa = 0.71, p < 0.001).
MR imaging was accurate for predicting reparable meniscal tears and was sensitive for the determination of nonreparable tears.
本研究旨在评估磁共振成像（MR成像）对膝关节半月板撕裂形态分类的准确性。
回顾性分析110例经关节镜检查确诊为半月板撕裂患者的1.5T快速自旋回波MR图像，由两名阅片者独立将其分为五种形态：水平型、纵行型、放射状、斜行型和复合型。将MR成像分类结果与作为参考标准的关节镜检查结果进行比较。还对纵行和斜行撕裂进行合并分析，因为这些撕裂通常可修复；对水平、放射状和复合型撕裂进行合并分析，因为这些撕裂通常不可修复。采用kappa系数计算观察者间和观察者内的一致性。
关节镜检查时，半月板撕裂分类为水平型（n = 44）、纵行型（n = 34）、复合型（n = 22）、放射状（n = 11）和斜行型（n = 5）。每位阅片者对可修复撕裂的敏感度、特异度和准确度分别为82%、92%和89%；以及59%、97%和84%。观察者1与观察者2的首次和第二次解读之间的观察者间一致性为中等（kappa分别为0.25，p < 0.005；以及kappa为0.21，p < 0.05）。观察者内一致性较高（kappa = 0.71，p < 0.001）。
MR成像在预测可修复半月板撕裂方面准确，在确定不可修复撕裂方面敏感。
