Qian Yue-Nan, Liu Fang, Dong Yi-Long, Cai Chun-Yuan
Department of Joint Surgery, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China;
Zhongguo Gu Shang. 2018 Mar 25;31(3):263-266. doi: 10.3969/j.issn.1003-0034.2018.03.014.
To explore diagnostic value of MRI on posterior root tear of medial and lateral meniscus.
From January 2012 to January 2016, clinical data of 43 patients with meniscal posterior root tear confirmed by arthroscopy were retrospective analyzed, including 25 males and 18 females, aged from 27 to 69 years old with an average age of(42.5±8.3)years old;27 cases on the right side and 16 cases on the left side. MRI examinations of 43 patients with tear of posterior meniscus root confirmed by knee arthroscopies were retrospectively reviewed. MRI images were double-blinded, independently, retrospectively scored by two imaging physicians. Sensitivity, specificity and accuracy of MRI diagnosis of lateral and medial meniscus posterior root tear were calculated, and knee ligament injury and meniscal dislocation were calculated.
Forty-three of 143 patients were diagnosed with meniscus posterior root tears by arthroscopy, including 19 patients with lateral tears and 24 patients with medial tears. The sensitivity, specificity and accuracy in diagnosis of posterior medial meniscus root tears for doctor A were 91.67%, 86.6% and 83.9% respectively, and for doctor B were 87.5%, 87.4% and 87.4%, 19 patients with medial meniscal protrusion and 2 patients with anterior cruciate ligament tear. The sensitivity, specificity and accuracy in diagnosis of posterior lateral meniscus root tears for doctor A were 73.7%, 79.9% and 79% respectively, and for doctor B were 78.9%, 82.3% and 82.5%, 4 patients with lateral meniscus herniation and 16 patients with cruciate ligament tear. Kappa statistics for posterior medial meniscus root tears and posterior lateral meniscus root tears were 0.84 and 0.72.
MRI could effectively demonstrate imaging features of medial and lateral meniscal root tear and its accompanying signs. It could provide the basis for preoperative diagnosis of clinicians, and be worthy to be popularized.
探讨MRI对内外侧半月板后根撕裂的诊断价值。
回顾性分析2012年1月至2016年1月间43例经关节镜证实为半月板后根撕裂患者的临床资料，其中男25例，女18例，年龄27～69岁，平均（42.5±8.3）岁；右侧27例，左侧16例。对43例经膝关节镜证实为半月板后根撕裂患者的MRI检查进行回顾性分析。MRI图像由两名影像科医师进行双盲、独立、回顾性评分。计算MRI诊断外侧和内侧半月板后根撕裂的敏感度、特异度和准确度，并计算膝关节韧带损伤和半月板脱位情况。
143例患者中43例经关节镜诊断为半月板后根撕裂，其中外侧撕裂19例，内侧撕裂24例。医生A诊断内侧半月板后根撕裂的敏感度、特异度和准确度分别为91.67%、86.6%和83.9%，医生B分别为87.5%、87.4%和87.4%，内侧半月板突出19例，前交叉韧带撕裂2例。医生A诊断外侧半月板后根撕裂的敏感度、特异度和准确度分别为73.7%、79.9%和79%，医生B分别为78.9%、82.3%和82.5%，外侧半月板疝4例，交叉韧带撕裂16例。内侧半月板后根撕裂和外侧半月板后根撕裂的Kappa值分别为0.84和0.72。
MRI能有效显示内外侧半月板根撕裂的影像特征及其伴随征象。可为临床医生术前诊断提供依据，值得推广。
