Kijowski Richard, Blankenbaker Donna G, Shinki Kazuhiko, Fine Jason P, Graf Ben K, De Smet Arthur A
Department of Radiology, University of Wisconsin Hospital, Clinical Science Center E3/311, Madison, WI 53792-3252, USA.
Radiology. 2008 Aug;248(2):571-8. doi: 10.1148/radiol.2482071234. Epub 2008 Jun 13.
To retrospectively compare the sensitivity and specificity of previously described magnetic resonance (MR) imaging criteria for the detection of instability in patients with juvenile or adult osteochondritis dissecans (OCD) of the knee, with arthroscopic findings as the reference standard.
Informed consent was waived by the Institutional Review Board for this HIPAA-compliant study. The study group consisted of 32 skeletally immature patients (25 boys, seven girls; mean age, 14.4 years) with 36 juvenile OCD lesions of the knee and 33 skeletally mature patients (25 men, eight women; mean age, 26.2 years) with 34 adult OCD lesions of the knee. All patients had been evaluated with MR imaging and arthroscopy. MR studies were retrospectively reviewed by two radiologists in consensus to determine the presence of previously described MR imaging criteria for OCD instability (ie, high T2 signal intensity rim, surrounding cysts, high T2 signal intensity cartilage fracture line, and fluid-filled osteochondral defect). Sensitivity and specificity of the criteria were calculated separately for juvenile and adult OCD lesions.
Separately, previously described MR imaging criteria for detection of OCD instability were 0%-88% sensitive and 21%-100% specific for juvenile OCD lesions and 27%-54% sensitive and 100% specific for adult OCD lesions. When used together, the criteria were 100% sensitive and 11% specific for instability in juvenile OCD lesions and 100% sensitive and 100% specific for instability in adult OCD lesions.
Previously described MR imaging criteria for OCD instability have high specificity for adult but not juvenile lesions of the knee.
回顾性比较先前描述的磁共振（MR）成像标准检测青少年或成人膝关节剥脱性骨软骨炎（OCD）患者关节不稳定的敏感性和特异性，以关节镜检查结果作为参考标准。
本符合健康保险流通与责任法案（HIPAA）的研究经机构审查委员会批准豁免了知情同意。研究组包括32例骨骼未成熟患者（25例男孩，7例女孩；平均年龄14.4岁），有36处青少年膝关节OCD病变，以及33例骨骼成熟患者（25例男性，8例女性；平均年龄26.2岁），有34处成人膝关节OCD病变。所有患者均接受了MR成像和关节镜检查。两位放射科医生对MR研究进行回顾性共同评估，以确定是否存在先前描述的OCD不稳定的MR成像标准（即高T2信号强度边缘、周围囊肿、高T2信号强度软骨骨折线和充满液体的骨软骨缺损）。分别计算青少年和成人OCD病变标准的敏感性和特异性。
单独来看，先前描述的用于检测OCD不稳定的MR成像标准对青少年OCD病变的敏感性为0% - 88%，特异性为21% - 100%；对成人OCD病变的敏感性为27% - 54%，特异性为100%。综合使用这些标准时，对青少年OCD病变不稳定的敏感性为100%，特异性为11%；对成人OCD病变不稳定的敏感性为100%，特异性为100%。
先前描述的用于OCD不稳定的MR成像标准对成人膝关节病变具有高特异性，但对青少年病变则不然。
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