Leigheb Massimiliano, Guzzardi Giuseppe, Barini Michela, Abruzzese Michele, Riva Silvia, Paschè Alessio, Pogliacomi Francesco, Rimondini Lia, Stecco Alessandro, Grassi Federico Alberto, Carriero Alessandro
Orthopaedics and Traumatology, A.O.U. "Maggiore d.c." Universiy of Eastern Piedmont, Novara.
Acta Biomed. 2018 Dec 10;90(1-S):116-122. doi: 10.23750/abm.v90i1-S.7977.
Objective The aim of this work is to evaluate the diagnostic accuracy of 0.3T sectoral MR imaging, compared with arthroscopy, for meniscal, cruciate ligaments and chondral knee lesions. Materials and Methods We conducted a retrospective study analyzing all the consecutive knees subjected to arthroscopy at our institution between January 2014 and June 2017 and preceded within 3 months by knee MR examination at our institution with 0.3 T equipment. Patients with history of a new trauma in the time interval between MR exam and arthroscopy were excluded from the study. Two independent experienced radiologists evaluated in double blind the MR findings of menisci, cruciate ligaments and articular cartilage. Both radiological findings were independently compared with those of the arthroscopic report considered as gold standard. For each of the examined targets we calculated the following parameters: sensitivity, specificity, accuracy, positive and negative predictive value; interobserver concordance statistically calculated using Cohen's Kappa test. Results 214 knees (95R/119L) of 214 patients (143M/71F) aged from 18 to 72 years (mean 44) were included and analyzed. We found a good diagnostic accuracy of the low field MR in identifying the injuries of the menisci (93%) and the crossed ligaments (96%), but a lower accuracy for the articular cartilage (85%). Sensitivity resulted 90% for menisci, 73% for ligaments and 58% for cartilage. Specificity was 91% for menisci, 97% for ligaments and 92% for cartilage. Inter-observer concordance resulted to be excellent for cruciate ligaments (K of Cohen's test = 0.832), good (K = 0.768) for menisci, modest to moderate for articular cartilage (K from 0.236 to 0.389) with worse concordance for tibial cartilage. Conclusions Low-field MR sectoral device with dedicated joint equipment confirms its diagnostic reliability for the evaluation of meniscal and cruciate ligaments lesions but is weak in evaluating low grade chondral lesions.
目的 本研究旨在评估0.3T扇形磁共振成像(MR)与关节镜检查相比,对半月板、交叉韧带和膝关节软骨损伤的诊断准确性。材料与方法 我们进行了一项回顾性研究,分析了2014年1月至2017年6月期间在我院接受关节镜检查的所有连续膝关节病例,这些病例在关节镜检查前3个月内于我院使用0.3T设备进行了膝关节MR检查。在MR检查和关节镜检查之间有新创伤史的患者被排除在研究之外。两名经验丰富的独立放射科医生对半月板、交叉韧带和关节软骨的MR检查结果进行双盲评估。将两个放射学检查结果分别与被视为金标准的关节镜检查报告结果进行独立比较。对于每个检查目标,我们计算了以下参数:敏感性、特异性、准确性、阳性预测值和阴性预测值;使用Cohen's Kappa检验进行统计学计算观察者间的一致性。结果 纳入并分析了214例患者(143例男性/71例女性)的214个膝关节(95个右侧/119个左侧),患者年龄在18至72岁之间(平均44岁)。我们发现低场MR在识别半月板损伤(93%)和交叉韧带损伤(96%)方面具有良好的诊断准确性,但在评估关节软骨损伤方面准确性较低(85%)。半月板的敏感性为90%,韧带为73%,软骨为58%。半月板的特异性为91%,韧带为97%,软骨为92%。观察者间的一致性在交叉韧带方面为优秀(Cohen检验的K值 = 0.832),半月板为良好(K = 0.768),关节软骨为中等至适度(K值从0.236至0.389),胫骨软骨的一致性较差。结论 配备专用关节设备的低场MR扇形装置在评估半月板和交叉韧带损伤方面证实了其诊断可靠性,但在评估低度软骨损伤方面较弱。