[膝关节和踝关节剥脱性骨软骨炎的磁共振断层扫描分期。与传统放射学及关节镜检查的比较]
[The staging of osteochondritis dissecans in the knee and ankle joints with MR tomography. A comparison with conventional radiology and arthroscopy].
作者信息
Bachmann G, Jürgensen I, Siaplaouras J
机构信息
Abteilung Diagnostische Radiologie, Justus-Liebig-Universität, Giessen.
出版信息
Rofo. 1995 Jul;163(1):38-44. doi: 10.1055/s-2007-1015941.
PURPOSE
A prospective study was performed on 50 patients suffering from osteochondritis dissecans of the knee and ankle to define criteria for stability and fixation of osteochondral lesions.
METHODS
Morphological parameters in MRI (size, fragmentation, cartilage, interface) and conventional radiology (separation, fragmentation) were registered and compared with arthroscopic staging. MRI staging based on different types of interfaces was demonstrated on T1- and T2-weighted images.
RESULTS
MRI could correctly predict a Grade 1 lesion in 50%, a Grade 2 lesion in 90%, a Grade 3 lesion in 0%, and a Grade 4 lesion in 79%. Stable lesions were differentiated from unstable lesions in 90%. Radiographic findings corresponded with arthroscopic staging in only 56% of the cases because fibrotic connection may guarantee stability in cases of bony separation.
CONCLUSION
MRI should be performed before therapy to select those patients who do not need surgical therapy or arthroscopy.
目的
对50例患有膝关节和踝关节剥脱性骨软骨炎的患者进行前瞻性研究，以确定骨软骨损伤的稳定性和固定标准。
方法
记录MRI（大小、碎裂、软骨、界面）和传统放射学（分离、碎裂）中的形态学参数，并与关节镜分期进行比较。基于不同类型界面的MRI分期在T1加权和T2加权图像上得到展示。
结果
MRI能够正确预测1级损伤的准确率为50%，2级损伤为90%，3级损伤为0%，4级损伤为79%。在90%的情况下，稳定损伤与不稳定损伤得以区分。X线检查结果仅在56%的病例中与关节镜分期相符，因为在骨质分离的情况下，纤维连接可能保证稳定性。
结论
在治疗前应进行MRI检查，以筛选出那些不需要手术治疗或关节镜检查的患者。
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