Kleinrok Krzysztof, Podsiadło Kaja, Sorysz Tomas, Urbanik Andrzej
Katedra Radiologii, Uniwersytet Jagielloński, Collegium Medicum.
Przegl Lek. 2013;70(5):293-8.
In the clinical practice, diagnostics with magnetic resonance imaging (MRI) in patients with knee trauma is performed at different times after the injury. This is due to the limited availability of MRI. Related causes, but also clinical considerations, cause the performing of arthroscopy in a different time from the MRI examination. To assess whether the time that elapses between the injury and MRI has an impact on the magnetic resonance diagnostic ability and whether it is affected by the time interval between MRI and arthroscopy. The results of the MRI and arthroscopy were analyzed in the group of 128 patients, 56 (44%) women and 72 (56%) men aged 12.9-62.5 years (mean 30.6) after the knee trauma. Next, the group of patients was divided depends on whether MRI examination was performed in shorter or longer time then 6 weeks after the trauma, into two subgroups: 52 patients (21 women and 31 men) with recent injury and 76 patients (35 woman and 41 men) with inveterate injury. Moreover, the group of patients was divided into two subgroups: 60 patients (26 women and 34 men) with the time between MRI examination and arthroscopy no longer than 30 days and group of 68 patients (30 women and 38 men) with time of waiting for arthroscopy longer than 30 days. Damage to the structures of the knee observed in MRI were classified in terms of location and severity. We compared the diagnostic ability of MRI and arthroscopy in the presence and severity of posttraumatic lesions of the knee. The statistical significance of presence of the injury in MRI and arthroscopy was estimated by the X2 test. Statistical analysis of the structures of the knee joint which are most commonly damaged after the trauma, which means both menisci and the anterior cruciate ligament (ACL) - was performed in whole group and separately in each subgroup. The results were compared between corresponding subgroups, and also between each subgroup and whole group. The diagnostic efficacy indices were compared using the test for differences between two structure indicators. The estimation of statistically significant differences was performed at the level of p<or=0.05. There was no statistically significant differences betweeen the indicators of the efficacy of MRI in recent and inveterate injuries, and also with increased delay between the MRI and arthroscopy examinations. Increasing the time between the injury and the MRI examination does not reduced the diagnostic efficacy of this methods. Increasing the time inverval between MRI and arthsroscopy does not matter about the compatibility of the results received in both techniques.
在临床实践中，膝关节创伤患者的磁共振成像（MRI）诊断在受伤后的不同时间进行。这是由于MRI的可用性有限。相关原因以及临床考虑因素导致关节镜检查与MRI检查在不同时间进行。为了评估受伤与MRI之间的时间间隔是否会影响磁共振诊断能力，以及它是否受MRI与关节镜检查之间时间间隔的影响。对128例膝关节创伤后的患者进行了分析，其中56例（44%）为女性，72例（56%）为男性，年龄在12.9 - 62.5岁（平均30.6岁）。接下来，根据MRI检查是在创伤后6周以内还是以外进行，将患者组分为两个亚组：52例（21例女性和31例男性）近期受伤患者和76例（35例女性和41例男性）陈旧性损伤患者。此外，患者组还被分为两个亚组：60例（26例女性和34例男性）MRI检查与关节镜检查之间的时间间隔不超过30天的患者，以及68例（30例女性和38例男性）等待关节镜检查时间超过30天的患者。MRI观察到的膝关节结构损伤根据位置和严重程度进行分类。我们比较了MRI和关节镜检查在膝关节创伤后病变的存在及严重程度方面的诊断能力。通过X²检验估计MRI和关节镜检查中损伤存在的统计学意义。对创伤后最常受损的膝关节结构，即半月板和前交叉韧带（ACL）进行了整体组及每个亚组的单独统计分析。对相应亚组之间以及每个亚组与整体组之间的结果进行了比较。使用两个结构指标差异检验比较诊断效能指标。在p≤0.05水平进行统计学显著差异估计。近期损伤和陈旧性损伤中MRI效能指标之间以及MRI与关节镜检查之间延迟增加时均无统计学显著差异。受伤与MRI检查之间时间增加并不会降低该方法的诊断效能。MRI与关节镜检查之间时间间隔增加并不影响两种技术所得结果的兼容性。
