临床、MRI、关节镜3种检查诊断半月板损伤
投稿时间:2017-01-14  修订日期:2017-02-05  点此下载全文
引用本文:赵博,李璐兵,郑辉,帕尔哈提,王雪,李飞,艾克热木,贾卫东,王成伟.临床、MRI、关节镜3种检查诊断半月板损伤[J].医学研究杂志,2017,46(10):143-146
DOI: 10.11969/j.issn.1673-548X.2017.10.036
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作者单位E-mail
赵博 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
李璐兵 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
郑辉 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
帕尔哈提 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
王雪 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
李飞 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
艾克热木 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科  
贾卫东 乌鲁木齐市第一人民医院骨科  
王成伟 830002 乌鲁木齐, 新疆医科大学第六附属医院骨病矫形修复科 footankle@163.com 
基金项目:新疆维吾尔自治区乌鲁木齐市科学技术计划项目(Y111310026)
中文摘要:目的 探讨临床检查与MRI对半月板损伤诊断价值。方法 自2011年1月~2014年4月纳入200例患者,对患膝进行临床检查、MRI及关节镜下诊疗。以关节镜下诊断为标准进行对临床检查和MRI诊断半月板损伤的敏感度、特异性、准确性及Kappa值并进行χ2检验统计分析。结果 临床试验检查诊断半月板损伤敏感度、特异性、准确性分别为87%、35%、75%,与关节镜组比较差异无统计学意义;MRI诊断半月板损伤敏感度、特异性、准确性分别为95%、9%、77%,与关节镜组比较差异有统计学意义;MRI诊断半月板撕裂损伤敏感度、特异性、准确性分别为82%、93%、88%,与关节镜下诊断比较差异无统计学意义。结论 临床检查和MRI对半月板损伤诊断敏感度较高,需密切结合诊断;MRI对半月板撕裂诊断符合率较高,为无创诊断首选,并减少不必要的手术治疗;较好的指导临床治疗。
中文关键词:膝关节  半月板损伤  MRI  关节镜
 
Diagnosis of Meniscus Injury in Clinical, MRI and Arthroscopy
Abstract:Objective To discuss the value of using clinical tests and MRI to diagnose the meniscus injury. Methods This paper quote 200 patients from January 2011 to April 2014.The study was done on the reliability and value of clinical tests and MRI in diagnosis of meniscus injury. Chi-square statistic analysis was done to study the examination tests and MRI in the diagnosis of meniscal injury degree compared with the standard of arthroscopy by sensitivity, specific, accurate and Kappa value. Results The sensitivity,specificity and accuracy of clinical tests diagnosis of meniscus injury were 87%,35% and 75% respectively. There was not statistically significant difference between arthroscopic diagnosis and clinical diagnosis. The sensitivity, specificity and accuracy of MRI diagnosis of meniscus injury were 95%, 9% and 77% respectively.There was statistically significant difference between arthroscopic diagnosis and clinical diagnosis. The sensitivity, specificity and accuracy of MRI diagnosis of meniscus tears were 82%,93% and 88% respectively.The difference between arthroscopic and MRI diagnosis of meniscus tears had no statistically significance. Conclusion Sensitivity of clinical texts and MRI diagnosis of meniscus injury is high. And clinical texts should be combined with MRI closely to diagnose. Coincidence rate of MRI for diagnosis of meniscus tears is higher. So it is the first choice of noninvasive diagnostic, and it con reduce the unnecessary operation treatment, and guide the clinical treatment better.
keywords:Knee joint  Meniscus injury  MRI  Arthroscopy
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