Kijowski Richard, Rosas Humberto, Williams Adam, Liu Fang
Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-3252, USA.
Radiology and Imaging Consultants, 1400 East Boulder Street, Colorado Springs, USA.
Skeletal Radiol. 2017 Oct;46(10):1353-1360. doi: 10.1007/s00256-017-2695-5. Epub 2017 Jun 26.
To compare magnetic resonance imaging (MRI) characteristics of torn and untorn post-operative menisci.
The study group consisted of 140 patients with 148 partially resected menisci who were evaluated with a repeat knee MRI examination and subsequent repeat arthroscopic knee surgery. Two musculoskeletal radiologists retrospectively assessed the following MRI characteristics of the post-operative meniscus: contour (smooth or irregular), T2 line through the meniscus (no line, intermediate signal line, intermediate-to-high signal line, and high fluid-like signal line), displaced meniscus fragment, and change in signal pattern through the meniscus compared with baseline MRI. Positive predictive values (PPV) and negative predictive values (NPV) were calculated using arthroscopy as the reference standard.
All 36 post-operative menisci with no T2 line were untorn at surgery (100% NPV), whereas 46 of the 79 post-operative menisci with intermediate T2 line, 16 of the 18 post-operative menisci with intermediate-to-high T2 line, and 14 of the 15 post-operative menisci with high T2 line were torn at surgery (58.2%, 88.9%, and 93.3% PPV respectively). Additional MRI characteristics associated with torn post-operative meniscus at surgery were irregular meniscus contour (PPV 85.7%), displaced meniscus fragment (PPV 100%), and change in signal pattern through the meniscus (PPV 99.4%).
Post-operative menisci with no T2 signal line were untorn at surgery. The most useful MRI characteristics for predicting torn post-operative menisci at surgery were change in signal pattern through the meniscus compared with baseline MRI, and displaced meniscus fragment followed by high T2 line through the meniscus, intermediate-to-high T2 line through the meniscus, and irregular meniscus contour.
比较术后半月板撕裂和未撕裂的磁共振成像（MRI）特征。
研究组由140例患者的148个部分切除的半月板组成，这些患者接受了膝关节MRI复查及随后的膝关节再次关节镜手术。两名肌肉骨骼放射科医生回顾性评估了术后半月板的以下MRI特征：轮廓（光滑或不规则）、穿过半月板的T2线（无信号线、中等信号线、中等至高信号线和高液样信号线）、半月板碎片移位以及与基线MRI相比半月板信号模式的变化。以关节镜检查为参考标准计算阳性预测值（PPV）和阴性预测值（NPV）。
所有36个术后无T2线的半月板在手术中未撕裂（NPV为100%），而79个术后有中等T2线的半月板中有46个、18个术后有中等至高T2线的半月板中有16个、15个术后有高T2线的半月板中有14个在手术中撕裂（PPV分别为58.2%、88.9%和93.3%）。与手术中术后半月板撕裂相关的其他MRI特征包括半月板轮廓不规则（PPV 85.7%）、半月板碎片移位（PPV 100%）以及半月板信号模式的变化（PPV 99.4%）。
术后无T2信号线的半月板在手术中未撕裂。预测手术中术后半月板撕裂最有用的MRI特征是与基线MRI相比半月板信号模式的变化、半月板碎片移位，其次是穿过半月板的高T2线、穿过半月板的中等至高T2线和半月板轮廓不规则。
