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关节镜下前交叉韧带损伤的临床治疗与关节并发症及 CT 观察。

Arthroscopic Anterior Cruciate Ligament Injury in Clinical Treatment of Joint Complications and CT Observation.

机构信息

Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Orthopedics Department, Hangzhou 310006, Zhejiang, China.

Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Anesthesiology Department, Hangzhou 310006, Zhejiang, China.

出版信息

J Healthc Eng. 2021 Feb 22;2021:6667046. doi: 10.1155/2021/6667046. eCollection 2021.

Abstract

Arthroscopy is the gold standard for diagnosing ACL injuries. It is a dual clinical technique for examination and treatment, which can effectively target the injury site for repair and treatment and can also accurately identify the lesion site and determine the degree of ligament injury through visual and three-dimensional observation of ligament injuries that are difficult to detect on imaging. However, this technique is invasive, so the clinic still needs to improve the related auxiliary imaging examination. In this paper, we performed MPR and VRT on patients with ACL injury and postprocessed the data. The diagnostic compliance rate of dual-source CT was 91.67% (33/36), the true positive rate was 93.33% (28/30), the missed rate was 6.67% (2/30), the true negative rate was 83.33% (5/6), and the misdiagnosis rate was 83.33% (5/6). The rate of true negative was 83.33% (5/6), and the rate of false diagnosis was 16.67% (1/6). Kappa analysis of the consistency between dual-source CT and arthroscopy showed a Kappa value of 0.719, indicating a high degree of consistency between the two examinations. In conclusion, MPR and VRT images are of clinical value for the diagnosis of ACL injury. In addition, dual-source CT can measure the CT value of the ACL and the thickness of each segment by MPR and VRT postprocessing techniques to diagnose the ligament injury in an objective, quantitative, and noninvasive way and can use dual-energy staining techniques to predict the ligament injury in a more intuitive way, which is not available in some arthroscopes.

摘要

关节镜检查是诊断 ACL 损伤的金标准。它是一种兼具检查和治疗功能的双重临床技术,能够有效针对损伤部位进行修复和治疗,同时通过对影像学上难以检测到的韧带损伤进行直观和三维观察,还能准确识别病变部位并确定韧带损伤程度。然而,这种技术具有侵入性,因此临床仍需要改进相关辅助影像检查。在本文中,我们对 ACL 损伤患者进行了 MPR 和 VRT 检查,并对数据进行了后处理。双源 CT 的诊断符合率为 91.67%(33/36),真阳性率为 93.33%(28/30),漏诊率为 6.67%(2/30),真阴性率为 83.33%(5/6),误诊率为 83.33%(5/6)。真阴性率为 83.33%(5/6),假阳性率为 16.67%(1/6)。双源 CT 与关节镜检查的一致性 Kappa 分析显示 Kappa 值为 0.719,表明两种检查具有高度一致性。总之,MPR 和 VRT 图像对 ACL 损伤的诊断具有临床价值。此外,双源 CT 可以通过 MPR 和 VRT 后处理技术测量 ACL 的 CT 值和各段厚度,以客观、定量、无创的方式诊断韧带损伤,并可利用双能量染色技术更直观地预测韧带损伤,这在某些关节镜中是无法实现的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20d6/7925042/14d9481582ed/JHE2021-6667046.001.jpg

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