Yadav Vijendra, Chandrashekhar Chidanand Kaudki Janekunte, Ram Rishi Pothuri, Mohammed Rafeeq
Sanjay Gandhi Institute of Trauma and Orthopedics, Bangalore, Karnataka, Índia.
Rev Bras Ortop (Sao Paulo). 2024 Dec 7;59(5):e707-e711. doi: 10.1055/s-0044-1785508. eCollection 2024 Oct.
The present study endeavors to scrutinize the precision of magnetic resonance imaging as a diagnostic modality for detecting ligament disruption of the knee, with arthroscopy serving as the gold standard. The study delves into the sensitivity, specificity, positive predictive value, and negative predictive value of magnetic resonance imaging (MRI) results in a cohort of 200 patients against diagnostic arthroscopy. Our institution conducted a comprehensive clinical examination of all patients with knee injuries, and those with affirmative findings suggestive of ligament disruption were subjected to an MRI scan. The study comprised 200 patients with MRI-confirmed anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears, who subsequently underwent arthroscopy for both diagnostic and therapeutic purposes. The results were subjected to various statistical tests to compare and analyze the outcomes. The study has demonstrated a remarkably high sensitivity and specificity, providing near-optimal accuracy for the diagnosis of ACL and PCL injuries via MRI compared with arthroscopy. Patients with affirmative MRI findings could proceed to undergo diagnostic/therapeutic arthroscopic procedures. The study emphasizes the significance of MRI as a noninvasive and highly precise method for assessing ligament injuries in the knee. Although MRI can be used as a first-line investigation, it must be emphasized that arthroscopy remains the gold standard for diagnosing ACL and PCL tears. The current study recommends the use of MRI as a valuable screening tool in patients with suspected knee ligament disruption, with potential to reduce the number of diagnostic arthroscopies in patients with inconclusive clinical findings, thereby minimizing patient discomfort and healthcare costs.
本研究旨在以关节镜检查作为金标准，仔细审查磁共振成像作为检测膝关节韧带损伤的诊断方法的准确性。该研究深入探讨了200名患者队列中磁共振成像（MRI）结果相对于诊断性关节镜检查的敏感性、特异性、阳性预测值和阴性预测值。
我们机构对所有膝关节损伤患者进行了全面的临床检查，对那些有韧带损伤肯定性发现的患者进行了MRI扫描。该研究包括200名经MRI确诊为前交叉韧带（ACL）和后交叉韧带（PCL）撕裂的患者，这些患者随后接受了用于诊断和治疗目的的关节镜检查。对结果进行了各种统计测试，以比较和分析结果。
该研究显示出非常高的敏感性和特异性，与关节镜检查相比，通过MRI诊断ACL和PCL损伤提供了近乎最佳的准确性。MRI检查结果呈阳性的患者可以继续接受诊断性/治疗性关节镜手术。
该研究强调了MRI作为评估膝关节韧带损伤的一种非侵入性且高度精确的方法的重要性。虽然MRI可以用作一线检查，但必须强调的是，关节镜检查仍然是诊断ACL和PCL撕裂的金标准。当前研究建议将MRI用作疑似膝关节韧带损伤患者的一种有价值的筛查工具，有可能减少临床检查结果不明确患者的诊断性关节镜检查数量，从而将患者的不适和医疗成本降至最低。
