Hashimoto Yusuke, Nishino Kazuya, Yamasaki Shinya, Nishida Yohei, Takahashi Shinji, Nakamura Hiroaki
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan.
Arch Orthop Trauma Surg. 2022 Aug;142(8):1971-1977. doi: 10.1007/s00402-021-04148-9. Epub 2021 Sep 6.
We evaluated the efficacy of two positioned magnetic resonance imaging (MRI) for visualizing the snapping phenomenon and detecting peripheral rim instability (PRI) in no-shift-type complete discoid lateral meniscus (CDLM).
The records of 39 patients diagnosed with no-shift-type CDLM under routine MRI who underwent arthroscopic surgery were reviewed. The snapping phenomenon and meniscal shift on two positioned MRI in full extension and deep flexion were evaluated and calculated the agreement between these findings. The positive predictive value (PPV), sensitivity, and specificity of meniscal shift on two positioned MRI for predicting PRI were calculated; PRI was further investigated according to anterior and posterior location. The hypotheses of this study were asfollows: (1) Two positioned MRI can visualize the snapping phenomenon and (2) Meniscal shift on two positioned MRI is an important predictive sign of detecting the instability site in no-shift-type CDLM.
The κ values between the snapping phenomenon and meniscal shift on two positioned MRI were 0.84. The snapping and two positioned MRI findings had high PPV (1.0, 0.96), sensitivity (0.82, 0.85), and specificity (1.0, 0.91) for predicting overall PRI. For anterior PRI, the snapping and posterior shift on two positioned MRI had moderate and high PPV (0.78, 0.9), high sensitivity (0.9, 0.9), and specificity (0.8, 0.89). The anterior shift on two positioned MRI findings predicted posterior PRI with high PPV (1.0) and specificity (1.0).
Two positioned MRI visualized the snapping phenomenon. Meniscal shift on two positioned MRI was an important predictive sign of overall PRI, anterior PRI, and posterior PRI in no-shift-type CDLM.
我们评估了两种定位磁共振成像(MRI)在可视化弹响现象及检测无移位型完全盘状外侧半月板(CDLM)的周边缘不稳定(PRI)方面的有效性。
回顾了39例经常规MRI诊断为无移位型CDLM且接受关节镜手术患者的记录。评估了在完全伸展和深度屈曲时两种定位MRI上的弹响现象和半月板移位情况,并计算了这些结果之间的一致性。计算了两种定位MRI上半月板移位对预测PRI的阳性预测值(PPV)、敏感性和特异性;根据前后位置进一步研究PRI。本研究的假设如下:(1)两种定位MRI可可视化弹响现象;(2)两种定位MRI上的半月板移位是检测无移位型CDLM不稳定部位的重要预测征象。
两种定位MRI上弹响现象与半月板移位之间的κ值为0.84。弹响及两种定位MRI结果对预测总体PRI具有较高的PPV(1.0,0.96)、敏感性(0.82,0.85)和特异性(1.0,0.91)。对于前侧PRI,两种定位MRI上的弹响及后侧移位具有中等和较高的PPV(0.78,0.9)、高敏感性(0.9,0.9)和特异性(0.8,0.89)。两种定位MRI结果上的前侧移位对后侧PRI具有较高的PPV(1.0)和特异性(1.0)。
两种定位MRI可可视化弹响现象。两种定位MRI上的半月板移位是无移位型CDLM总体PRI、前侧PRI和后侧PRI的重要预测征象。