Hodler J
Abteilung Radiologie, Universitätsklinik Balgrist, Zürich.
Ther Umsch. 1996 Oct;53(10):738-44.
Standard radiographs still represent the standard imaging method in knee abnormalities. Major advantages include high spatial resolution, low cost, high availability and standardized imaging technique. Because there is an increasing pressure on the cost of health care, additional imaging should only be employed based on a working hypothesis. In most cases MR imaging is most suitable for further diagnosis. In internal knee derangements MR imaging has been shown to have a high negative predictive value, thus obviating unnecessary surgery. MR imaging also is the imaging method of choice in the detection and follow-up of arthritis, in the detection, staging and follow-up of malignant neoplasms, and in the detection of occult fractures. Ultrasonography is useful in the characterization of superficial soft-tissue abnormalities, but has not gained high acceptance in searching for internal derangements of the knee. Scintigraphy is competing with MR imaging in the early detection of bone abnormalities and for follow-up. However, it is less expensive and can be employed for the evaluation of multilocular processes. CT has a limited role in the evaluation of complex fractures mainly of the tibial plateau.
标准X线片仍然是膝关节异常的标准成像方法。主要优点包括高空间分辨率、低成本、高可用性和标准化成像技术。由于医疗保健成本压力不断增加，只有基于有效的假设才应采用额外的成像检查。在大多数情况下，磁共振成像（MR成像）最适合进一步诊断。在膝关节内部紊乱方面，MR成像已被证明具有较高的阴性预测价值，从而避免了不必要的手术。MR成像也是检测和随访关节炎、检测、分期和随访恶性肿瘤以及检测隐匿性骨折的首选成像方法。超声检查有助于浅表软组织异常的特征性诊断，但在寻找膝关节内部紊乱方面尚未得到广泛认可。骨闪烁显像在早期检测骨异常和随访方面与MR成像相互竞争。然而，它成本较低，可用于评估多房性病变。CT在评估主要为胫骨平台的复杂骨折方面作用有限。
