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术后半月板:膝关节双源螺旋CT关节造影评估

Postoperative meniscus: assessment at dual-detector row spiral CT arthrography of the knee.

作者信息

Mutschler Céline, Vande Berg Bruno C, Lecouvet Frédéric E, Poilvache Pascal, Dubuc Jean-Emile, Maldague Baudouin, Malghem Jacques

机构信息

Department of Radiology, Cliniques universitaires St Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200 Brussels, Belgium.

出版信息

Radiology. 2003 Sep;228(3):635-41. doi: 10.1148/radiol.2283020590. Epub 2003 Jul 24.

Abstract

PURPOSE

To assess the effectiveness of dual-detector row spiral computed tomographic (CT) arthrography of the knee in the evaluation of the postoperative meniscus for recurrent or residual meniscal tear.

MATERIALS AND METHODS

Spiral CT arthrography was performed in 20 patients who presented with pain after partial meniscectomy. Findings at the initial reading of the images and at two retrospective independent readings were compared with those at second-look arthroscopy performed in all patients. At initial interpretation, conventional criteria for meniscal tear were used, including partial- or full-thickness tear of any size and meniscal separation. At retrospective interpretation, criteria for meniscal tear included large partial- and full-thickness tear and meniscal separation but not small partial-thickness tear. Sensitivity and specificity for the detection of tear of the postoperative menisci were calculated for initial and retrospective readings.

RESULTS

At initial interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 100% and 78%, respectively. At retrospective interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 79% and 89% at reading 1 and 93% and 89% at reading 2, respectively.

CONCLUSION

Spiral CT arthrography is valuable for the assessment of postoperative menisci, but the application of conventional definitions of meniscal tear to arthrographic findings in postoperative menisci can lead to overestimation of the clinical importance of meniscal lesions.

摘要

目的

评估双探测器排螺旋计算机断层扫描(CT)关节造影术在评估膝关节半月板切除术后复发性或残留半月板撕裂中的有效性。

材料与方法

对20例半月板部分切除术后出现疼痛的患者进行螺旋CT关节造影。将图像初次阅片及两次回顾性独立阅片的结果与所有患者的二次关节镜检查结果进行比较。初次解读时,采用半月板撕裂的传统标准,包括任何大小的部分或全层撕裂以及半月板分离。回顾性解读时,半月板撕裂的标准包括大的部分和全层撕裂以及半月板分离,但不包括小的部分厚度撕裂。计算初次和回顾性阅片检测术后半月板撕裂的敏感性和特异性。

结果

初次解读时,检测术后半月板撕裂的敏感性和特异性分别为100%和78%。回顾性解读时,第一次阅片检测术后半月板撕裂的敏感性和特异性分别为79%和89%,第二次阅片时分别为93%和89%。

结论

螺旋CT关节造影术对术后半月板的评估有价值,但将半月板撕裂的传统定义应用于术后半月板造影结果可能会高估半月板损伤的临床重要性。

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