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[计算机断层扫描和核磁共振成像在膝关节半月板损伤和韧带损伤术前诊断中的价值]

[Value of computerized tomography and nuclear magnetic resonance tomography in preoperative diagnosis of meniscus lesions and ligamentous lesions of the knee joint].

作者信息

Castro W H, Jerosch J, Assheuer J

机构信息

Klinik und Poliklinik für Allgemeine Orthopädie, Westfälischen Wilhelms-Universität Münster.

出版信息

Chirurg. 1991 May;62(5):394-8.

PMID:1874041
Abstract

In a prospective study, 53 patients with chronic complaints and acute injuries of the knee joint, were evaluated by clinical examination, CT-scanning and magnetic resonance imaging (MRI). Subsequently, arthroscopy or an open surgical procedure was performed. A total of 21 patients suffered from meniscal lesions. There were 17 ruptures of the medial and 4 ruptures of the lateral meniscus. In patients with meniscus ruptures, the sensitivity of both MRI and CT-scan was 86%, whereas the specificity of MRI was slightly lower than that of CT-scan. The accuracy and the predictive value were also slightly lower, although the difference was not significant. Fifteen patients suffered from acute or chronic ligament ruptures. In patients with anterior cruciate ligament (ACL) ruptures, all complete ACL ruptures had correctly been diagnosed by CT and MRI. Two out of four partial ACL ruptures were missed by MRI; only one was missed by CT-scan. Three medial collateral ligament ruptures were documented by MRI and two by CT-scanning. The high negative predictive value of CT and MRI can realize a reduction of the amount of diagnostic arthroscopies.

摘要

在一项前瞻性研究中,对53例膝关节慢性病症和急性损伤患者进行了临床检查、CT扫描和磁共振成像(MRI)评估。随后,进行了关节镜检查或开放手术。共有21例患者患有半月板损伤。内侧半月板破裂17例,外侧半月板破裂4例。在半月板破裂患者中,MRI和CT扫描的敏感性均为86%,而MRI的特异性略低于CT扫描。准确性和预测价值也略低,尽管差异不显著。15例患者患有急性或慢性韧带破裂。在前交叉韧带(ACL)破裂患者中,所有完全性ACL破裂均被CT和MRI正确诊断。4例部分ACL破裂中有2例被MRI漏诊;CT扫描仅漏诊1例。MRI记录了3例内侧副韧带破裂,CT扫描记录了2例。CT和MRI的高阴性预测价值可减少诊断性关节镜检查的数量。

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