Kececi Burcin, Bicer Elcil Kaya, Arkun Remide, Argin Mehmet, Taskiran Emin
Department of Orthopaedics and Traumatology, Faculty of Medicine, Ege University, 35100, Bornova, Izmir, Turkey,
Eur J Orthop Surg Traumatol. 2015 Jan;25(1):173-9. doi: 10.1007/s00590-014-1450-z. Epub 2014 Apr 10.
To evaluate the diagnostic value of direct magnetic resonance (MR) arthrography in detection of re-torn or unhealed menisci which were previously repaired.
Twenty-six menisci of 24 symptomatic patients who had undergone a meniscus repair surgery were included in this retrospective study. These patients had been evaluated with gadolinium-enhanced direct MR arthrography. A subsequent second-look arthroscopy was performed thereafter. The findings of MR arthrography were compared with the arthroscopic findings.
Sixteen recurrent meniscal lesions were detected with MR arthrography; the remaining ten repaired menisci were evaluated as healed. At second-look arthroscopy, six out of 26 repaired menisci were evaluated as completely healed. Eight of them had incomplete healing, and 12 of them were unhealed. MR arthrography had four false-negative results, but there were none false-positive results. It was arthroscopically shown that three of these four false-negative results were belonged to patients who had incomplete healing. MR arthrography had a sensitivity, specificity, and overall accuracy of 80, 100, and 84.6 %, respectively. When incomplete lesions were left out of analysis, its sensitivity and accuracy reached to 94.8 and 94.4 %.
The findings of this study showed that MR arthrography was a reliable diagnostic tool in evaluating previously repaired menisci. Yet diagnosis of incomplete meniscal lesions seemed to be challenging.
评估直接磁共振(MR)关节造影术对检测先前已修复的半月板再次撕裂或未愈合的诊断价值。
本回顾性研究纳入了24例有症状患者的26个半月板,这些患者均接受了半月板修复手术。对这些患者进行了钆增强直接MR关节造影评估。此后进行了二次关节镜检查。将MR关节造影的结果与关节镜检查结果进行比较。
MR关节造影检测到16例复发性半月板损伤;其余10个修复的半月板被评估为已愈合。在二次关节镜检查中,26个修复的半月板中有6个被评估为完全愈合。其中8个愈合不完全,12个未愈合。MR关节造影有4例假阴性结果,但无假阳性结果。关节镜检查显示,这4例假阴性结果中有3例属于愈合不完全的患者。MR关节造影的敏感性、特异性和总体准确率分别为80%、100%和84.6%。当不分析不完全损伤时,其敏感性和准确率分别达到94.8%和94.4%。
本研究结果表明,MR关节造影术是评估先前修复半月板的可靠诊断工具。然而,诊断半月板不完全损伤似乎具有挑战性。