Heron C W, Calvert P T
Department of Radiology, St George's Hospital, London, England.
Radiology. 1992 Jun;183(3):839-44. doi: 10.1148/radiology.183.3.1584944.
To compare the findings on magnetic resonance (MR) images of the knee obtained with a three-dimensional gradient-echo (GRE) sequence with findings at arthroscopy, the menisci, cruciate ligaments, and hyaline cartilage were assessed in 100 patients. At MR imaging (performed by means of fast imaging with steady-state precession) and arthroscopy, the menisci (n = 200) and areas of hyaline cartilage (n = 500) were assigned grades of zero (normal) to three (greatest abnormality). The cruciate ligaments were considered intact, partially torn, or completely torn. The sensitivity of MR imaging in diagnosis of meniscal tears seen at arthroscopy was 97% and the specificity, 94%. For complete tears of the anterior cruciate ligament, the sensitivity was 92% and specificity, 96%. In the posterior cruciate ligament, both the sensitivity and specificity were 100%. Good correlation existed between findings at MR imaging and those at arthroscopy in assessment of focal thinning and full-thickness loss of hyaline cartilage, but arthroscopy enabled superior visualization of minor fissuring. Three-dimensional GRE MR imaging enables accurate assessment of the articular cartilage of the knee. The evaluation of meniscal tears and the cruciate ligaments has a high negative predictive value.
为了比较采用三维梯度回波（GRE）序列获得的膝关节磁共振（MR）图像结果与关节镜检查结果，对100例患者的半月板、交叉韧带和透明软骨进行了评估。在MR成像（采用稳态进动快速成像进行）和关节镜检查时，半月板（n = 200）和透明软骨区域（n = 500）被分为0级（正常）至3级（最严重异常）。交叉韧带被视为完整、部分撕裂或完全撕裂。MR成像对关节镜检查所见半月板撕裂的诊断敏感性为97%，特异性为94%。对于前交叉韧带完全撕裂，敏感性为92%，特异性为96%。在后交叉韧带中，敏感性和特异性均为100%。在评估透明软骨的局灶性变薄和全层缺失时，MR成像结果与关节镜检查结果之间存在良好的相关性，但关节镜检查能更好地观察到微小裂隙。三维GRE MR成像能够准确评估膝关节的关节软骨。半月板撕裂和交叉韧带的评估具有较高的阴性预测价值。
