Adalberth T, Roos H, Laurén M, Akeson P, Sloth M, Jonsson K, Lindstrand A, Lohmander L S
Department of Orthopedics, Lund University Hospital, Sweden.
Am J Sports Med. 1997 Mar-Apr;25(2):231-7. doi: 10.1177/036354659702500217.
Forty patients with traumatic knee hemarthrosis were examined within 1 week after injury and observations made with magnetic resonance imaging, scintigraphy, arthroscopic evaluation, radiography, and physical examination were compared. Thirty-four patients (85%) had anterior cruciate ligament injuries according to the arthroscopic findings and 28 (83%) of these had associated meniscal tears. Magnetic resonance imaging confirmed the arthroscopic findings, especially if only meniscal tears that required surgery were taken into account (sensitivity, 94% for the lateral and 83% for the medial meniscus). However, the specificity of magnetic resonance imaging was only 29% and 27% for the lateral and medial menisci, respectively, and the accuracy was 28% and 50%, respectively. Marrow edemas, or bone bruises, were seen on magnetic resonance imaging in 80% of the patients and were mainly seen in the lateral compartment. Bone scans correlated well with magnetic resonance imaging findings of marrow edemas. Plain radiographs were normal in all but one case. We show that magnetic resonance imaging does not add information on the status of the anterior cruciate ligament compared with the clinical examination, and that it may be as good as arthroscopic evaluation for the diagnosis of meniscal tears that require surgery.
对40例创伤性膝关节积血患者在受伤后1周内进行了检查，并比较了磁共振成像、闪烁扫描、关节镜评估、X线摄影和体格检查的观察结果。根据关节镜检查结果，34例患者（85%）存在前交叉韧带损伤，其中28例（83%）伴有半月板撕裂。磁共振成像证实了关节镜检查结果，尤其是仅考虑需要手术的半月板撕裂时（外侧半月板敏感性为94%，内侧半月板为83%）。然而，磁共振成像对外侧和内侧半月板的特异性分别仅为29%和27%，准确性分别为28%和50%。80%的患者在磁共振成像上可见骨髓水肿或骨挫伤，主要见于外侧间室。骨扫描与骨髓水肿的磁共振成像结果相关性良好。除1例病例外，所有X线平片均正常。我们表明，与临床检查相比，磁共振成像并未提供有关前交叉韧带状态的额外信息，并且对于诊断需要手术的半月板撕裂，其可能与关节镜评估一样好。
