Macarini Luca, Murrone Mario, Marini Stefania, Mariano Michele, Zaccheo Nicola, Moretti Biagio
DiMIMP, Sezione di Diagnostica per Immagini, Università degli Studi, Policlinico di Bari, Bari, Italy.
Radiol Med. 2003 Apr;105(4):296-307.
To evaluate the diagnostic effectiveness of magnetic resonance (MR) in knee cartilage pathologies of different regions and grades with the aim of establishing the role of MR in treatment choice.
We enrolled 90 patients who underwent MR and arthroscopy of the knee. To classify cartilage lesions we used a simplified grading system that correlates MR to arthroscopic reports and divides lesions into low and high grades. The MR examinations were performed with a 1.5 T superconducting magnet with a standard protocol to obtain quality images in a short time, using T1-weighted spin-echo sequences, T2* weighted gradient-echo sequences and inversion recovery sequences. The MR diagnostic specificity, sensitivity and accuracy and MR positive predictive value and negative predictive value in identifying and grading the chondral lesions of the femorotibial and patellofemoral compartments were calculated and compared to arthroscopy parameters.
The analysis of each grade of chondral lesions reveals an MR accuracy of 94% in high-grade lesions of the femorotibial and patellofemoral compartments and an MR accuracy of 78% in low-grade lesions of patellofemoral compartment and of 70% in low-grade lesions of femorotibial compartment. This result suggests MR is useful for the grading of chondral lesions in clinical practice.
MR diagnostic effectiveness substantially changes according to the different location and grade of chondral lesions. While MR seems to be nearly equivalent to arthroscopy for high-grade lesions subject to surgery, it appears to be less accurate in diagnosing low-grade lesions, in particular femorotibial lesions.
评估磁共振成像（MR）在不同区域和分级的膝关节软骨病变中的诊断效能，旨在确定MR在治疗选择中的作用。
我们纳入了90例行膝关节MR和关节镜检查的患者。为了对软骨损伤进行分类，我们使用了一种简化的分级系统，该系统将MR与关节镜报告相关联，并将损伤分为低级和高级。MR检查使用1.5T超导磁体，采用标准方案，在短时间内获得高质量图像，使用T1加权自旋回波序列、T2*加权梯度回波序列和反转恢复序列。计算MR在识别和分级股骨胫和髌股关节软骨损伤方面的诊断特异性、敏感性、准确性以及MR阳性预测值和阴性预测值，并与关节镜检查参数进行比较。
对各分级软骨损伤的分析显示，在股骨胫和髌股关节高级别损伤中，MR的准确率为94%；在髌股关节低级别损伤中，MR的准确率为78%；在股骨胫关节低级别损伤中，MR的准确率为70%。这一结果表明，MR在临床实践中对软骨损伤分级是有用的。
MR的诊断效能因软骨损伤的不同位置和分级而有很大变化。虽然对于需要手术的高级别损伤，MR似乎与关节镜检查几乎等效，但在诊断低级别损伤，尤其是股骨胫关节损伤时，其准确性似乎较低。
