Tran Thi My Anh, Lim Beng Ghee, Sheehy Rohan, Robertson Patricia L
Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2019 Feb;63(1):54-60. doi: 10.1111/1754-9485.12840. Epub 2018 Dec 3.
Common peroneal nerve (CPN) injury occurs in 10-40% of patients following knee dislocation. Is magnetic resonance imaging (MRI) using routine knee protocols able to adequately evaluate CPN injury and predict long-term outcome?
Trauma patients presenting for knee MRI at a single public hospital, between July 2007 and May 2017, were retrospectively identified using radiology and orthopaedic databases. Medical records were retrieved for clinical scores. MRI images were scored by two independent radiologists blinded to the clinical CPN status and scores correlated with initial clinical scores using the Pearson correlation coefficient.
Final cohort included 107 patients (81 males and 26 females) with a mean age of 39 (range 19-81 years). MRI was considered to be adequate for coverage of the CPN in 84 patients. Fourteen patients had CPN injury clinically (seven complete and seven partial). Concordance between MRI scores and initial clinical scores was 0.456 (P = 0.01). MRI sensitivity and specificity for CPN injury on the 84 adequate scans were 54.5% and 93.2% respectively. All seven cases of partial CPN injury and three of seven cases of complete CPN injury recovered fully. High MRI scores of 5 and 8 were given for the two patients with a persisting complete CPN palsy. Highest scores for partial CPN injury subjects were 2 and 4.
Magnetic resonance imaging using a routine knee protocol is not adequate for the assessment of CPN injury in many subjects. More specific MRI neural sequences with complete CPN coverage may be worth trialing.
在膝关节脱位患者中，腓总神经（CPN）损伤的发生率为10% - 40%。使用常规膝关节检查方案的磁共振成像（MRI）能否充分评估CPN损伤并预测长期预后？
通过放射科和骨科数据库，对2007年7月至2017年5月期间在一家公立医院进行膝关节MRI检查的创伤患者进行回顾性识别。检索病历以获取临床评分。由两名对临床CPN状态不知情的独立放射科医生对MRI图像进行评分，并使用Pearson相关系数将评分与初始临床评分相关联。
最终队列包括107例患者（81例男性和26例女性），平均年龄39岁（范围19 - 81岁）。84例患者的MRI被认为足以覆盖CPN。14例患者临床上存在CPN损伤（7例完全损伤和7例部分损伤）。MRI评分与初始临床评分之间的一致性为0.456（P = 0.01）。在84次充分扫描中，MRI对CPN损伤的敏感性和特异性分别为54.5%和93.2%。所有7例部分CPN损伤病例和7例完全CPN损伤病例中的3例完全康复。两名持续性完全CPN麻痹患者的MRI评分为5分和8分。部分CPN损伤患者的最高评分为2分和4分。
使用常规膝关节检查方案的磁共振成像在许多受试者中不足以评估CPN损伤。具有完整CPN覆盖的更具特异性的MRI神经序列可能值得尝试。
