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3.0 特斯拉磁共振成像与关节镜检查用于评估膝关节软骨损伤

3.0-Tesla MRI and arthroscopy for assessment of knee articular cartilage lesions.

作者信息

Reed Marty E, Villacis Diego C, Hatch George F Rick, Burke Wendy S, Colletti Patrick M, Narvy Steven J, Mirzayan Raffy, Vangsness C Thomas

出版信息

Orthopedics. 2013 Aug;36(8):e1060-4. doi: 10.3928/01477447-20130724-24.

DOI:10.3928/01477447-20130724-24
PMID:23937754
Abstract

The purpose of this study was to evaluate the ability of 3.0-Tesla magnetic resonance imaging (MRI) to accurately assess knee articular cartilage lesions. Sixteen patients who had knee 3.0-T MRI and underwent knee arthroscopy for partial meniscectomy were included. Three fellowship-trained sports medicine orthopedic surgeons reviewed all images. Articular lesions on MRI were graded from I to IV and compared with arthroscopic grading using the Outerbridge and the International Cartilage Repair Society (ICRS) classifications. The articular surface was divided into 6 regions. Based on MRI findings, of the 288 articular surface evaluations, 113 (39%) surface evaluations were classified as disease-positive (grade 2 to 4). Kappa interrater reliability scores for MRI evaluation, Outerbridge classification, and ICRS classification were 0.13, 0.54, and 0.41, respectively. Using the Outerbridge classification as a reference standard, the sensitivity, specificity, and accuracy were 57%, 71%, and 63%, respectively. Using the ICRS classification, sensitivity, specificity, and accuracy were 59%, 71%, and 69%, respectively. When isolating the articular grading to the senior author on MRI evaluation vs Outerbridge classification, the sensitivity, specificity, and accuracy were 54%, 92%, and 75%, respectively. Based on the current findings, 3.0-T MRI is as an invaluable noninvasive tool with good diagnostic value for assessing articular cartilage lesions of the knee, although it may not be as sensitive and accurate as previously reported.

摘要

本研究的目的是评估3.0特斯拉磁共振成像(MRI)准确评估膝关节软骨损伤的能力。纳入了16例接受膝关节3.0-T MRI检查并因部分半月板切除术而接受膝关节镜检查的患者。三位接受过专科培训的运动医学骨科医生查看了所有图像。MRI上的关节损伤从I级到IV级进行分级,并与使用Outerbridge和国际软骨修复协会(ICRS)分类的关节镜分级进行比较。关节表面分为6个区域。根据MRI结果,在288次关节表面评估中,113次(39%)表面评估被分类为疾病阳性(2至4级)。MRI评估、Outerbridge分类和ICRS分类的Kappa评分者间可靠性分别为0.13、0.54和0.41。以Outerbridge分类作为参考标准,敏感性、特异性和准确性分别为57%、71%和63%。使用ICRS分类时,敏感性、特异性和准确性分别为59%、71%和69%。当在MRI评估与Outerbridge分类中仅将关节分级隔离给资深作者时,敏感性、特异性和准确性分别为54%、92%和75%。基于目前的研究结果,3.0-T MRI是一种评估膝关节软骨损伤具有良好诊断价值的宝贵无创工具,尽管它可能不如先前报道的那样敏感和准确。

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