经手术证实的半月板撕裂在膝关节磁共振成像（MRI）上的间接软组织和骨质征象。

Indirect soft-tissue and osseous signs on knee MRI of surgically proven meniscal tears.

作者信息

Bergin Diane, Hochberg Hilary, Zoga Adam C, Qazi Naila, Parker Laurence, Morrison William B

机构信息

Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19066, USA.

出版信息

AJR Am J Roentgenol. 2008 Jul;191(1):86-92. doi: 10.2214/AJR.07.3313.

DOI:10.2214/AJR.07.3313

PMID:18562729

Abstract

OBJECTIVE

The purpose of this study was to determine the frequency of abnormal MR signal intensity in soft tissues and osseous structures in association with surgically proven meniscal tears.

MATERIALS AND METHODS

Seventy patients underwent 1.5-T MRI of the knee and arthroscopy within 3 months. MR images were reviewed by two radiologists for parameniscal cysts, bowing and edema around the collateral ligament, meniscal extrusion, cartilage loss, and nonlinear and linear subchondral marrow edema. The findings were correlated with the arthroscopic findings. The positive predictive value (PPV), sensitivity, and specificity of indirect signs were calculated.

RESULTS

Fifty-three medial and 28 lateral meniscal tears were found at arthroscopy. The PPV of indirect signs of meniscal tear was 0.17-1.00 for reader 1 and 0.37-1.00 for reader 2. The PPV of parameniscal cysts was 1.00 for medial and lateral meniscal tears for both readers. The specificity and PPV of periligamentous edema and cruciate ligament bowing for medial meniscal tear were 0.94 and 0.98 for both readers, 0.88 and 0.94 for reader 1, and 0.94 and 0.97 for reader 2. The specificity and PPV of subchondral marrow edema for medial meniscal tear were 0.88 and 0.96 for reader 1 and 0.94 and 0.97 for reader 2 and for lateral meniscal tear were 0.98 and 0.92 for reader 1 and 1.00 and 1.00 for reader 2. The specificity and PPV of linear subchondral marrow edema for medial meniscal tear were 0.94 and 0.97 for reader 1 and 1.00 and 1.00 for reader 2. For lateral meniscal tear, the values were 0.98 and 0.89 for reader 1 and 1.00 and 1.00 for reader 2. The specificity and PPV of nonlinear subchondral marrow edema for medial meniscal tear were 0.94 and 0.89 for reader 1 and 1.00 and 1.00 for reader 2. For lateral meniscal tear, the values were 0.89 and 0.97 for reader 1 and 1.00 and 1.00 for reader 2. The specificity and PPV of cartilage loss for medial meniscal tear were 0.88 and 0.94 for reader 1 and 0.88 and 0.93 for reader 2. For lateral meniscal tear, the values were 0.85 and 0.56 for reader 1 and 0.97 and 0.80 for reader 2.

CONCLUSION

Indirect MRI signs occur in association with meniscal tears and can aid diagnostic confidence when the MRI meniscal appearance is equivocal.

摘要

目的

本研究的目的是确定与手术证实的半月板撕裂相关的软组织和骨结构中异常磁共振信号强度的频率。

材料与方法

70例患者在3个月内接受了膝关节1.5-T磁共振成像（MRI）检查及关节镜检查。两名放射科医生对磁共振图像进行了评估，观察半月板旁囊肿、侧副韧带周围的弓形改变和水肿、半月板挤出、软骨损伤以及非线性和线性软骨下骨髓水肿情况。将这些发现与关节镜检查结果进行关联分析。计算间接征象的阳性预测值（PPV）、敏感性和特异性。

结果

关节镜检查发现53例内侧半月板撕裂和28例外侧半月板撕裂。对于读者1，半月板撕裂间接征象的PPV为0.17 - 1.00，对于读者2为0.37 - 1.00。对于两位读者，半月板旁囊肿对于内侧和外侧半月板撕裂的PPV均为1.00。对于内侧半月板撕裂，韧带周围水肿和交叉韧带弓形改变的特异性和PPV，读者1分别为0.94和0.98，读者2分别为0.88和0.94；读者1分别为0.94和0.97，读者2分别为0.94和0.97。对于内侧半月板撕裂，软骨下骨髓水肿的特异性和PPV，读者1分别为0.88和0.96，读者2分别为0.94和0.97；对于外侧半月板撕裂，读者1分别为0.98和0.92，读者2分别为1.00和1.00。对于内侧半月板撕裂，线性软骨下骨髓水肿的特异性和PPV，读者1分别为0.94和0.97，读者2分别为1.00和1.00；对于外侧半月板撕裂，读者1分别为0.98和0.89，读者2分别为1.00和1.00。对于内侧半月板撕裂，非线性软骨下骨髓水肿的特异性和PPV，读者1分别为0.94和0.89，读者2分别为1.00和1.00；对于外侧半月板撕裂，读者1分别为0.89和0.97，读者2分别为1.00和1.00。对于内侧半月板撕裂，软骨损伤的特异性和PPV，读者1分别为0.88和0.94，读者2分别为0.88和0.93；对于外侧半月板撕裂，读者1分别为0.85和0.56，读者2分别为0.97和0.80。