Trieshmann H W, Mosure J C
Eastern Virginia Medical School, Norfolk, USA.
Arthroscopy. 1996 Oct;12(5):550-5. doi: 10.1016/s0749-8063(96)90193-0.
Although magnetic resonance imaging (MRI) of the knee is known to be an accurate technique for diagnosing soft tissue disorders of the knee, the value of MRI in improving patient outcome is controversial. The purpose of this project was to study the value of MRI in a subgroup of patients with knee pain and disability whose diagnosis was uncertain after standard orthopaedic evaluation. An extensive database was recorded prospectively for each of 208 patients providing clinical data as well as diagnoses from clinical, MRI, and surgical observations. These data were analyzed to determine the effect of MRI on diagnosis and patient outcome regarding surgical decision making. The overall diagnostic accuracy of MRI was determined to be 97% in patients undergoing arthroscopy. MRI differed from the clinical diagnosis in 33% of cases, the most common variance being diagnosis of meniscal tear. After combining the MRI and clinical information, surgical decision making was altered in 27% of cases. In a group of patients with acute knee symptoms, the decision not to proceed with surgery was made in 64% of cases. The study shows that MRI of the knee is a valuable tool for augmenting the diagnostic process. The data further show that MRI is a cost-effective technique for avoiding unnecessary surgery and affects patient outcome by improving surgical decision making.
尽管膝关节磁共振成像（MRI）是诊断膝关节软组织疾病的一项准确技术，但MRI在改善患者预后方面的价值仍存在争议。本项目的目的是研究MRI在一组膝关节疼痛和功能障碍患者中的价值，这些患者在经过标准的骨科评估后诊断仍不明确。前瞻性地记录了208例患者的广泛数据库，提供了临床数据以及来自临床、MRI和手术观察的诊断结果。对这些数据进行分析，以确定MRI对手术决策的诊断和患者预后的影响。在接受关节镜检查的患者中，MRI的总体诊断准确率为97%。MRI与临床诊断在33%的病例中存在差异，最常见的差异是半月板撕裂的诊断。将MRI和临床信息相结合后，27%的病例改变了手术决策。在一组有急性膝关节症状的患者中，64%的病例决定不进行手术。该研究表明，膝关节MRI是增强诊断过程的一项有价值的工具。数据进一步表明，MRI是一种避免不必要手术的经济有效的技术，并且通过改善手术决策影响患者预后。
