术前膝关节剥脱性骨软骨炎分级及稳定性的磁共振成像评估

发布时间：2019-02-19 17:47

【摘要】：目的评价磁共振(MR)成像检查评估膝关节剥脱性骨软骨炎(OCD)分级及稳定性的能力。方法由2名放射诊断医师独立回顾性分析47例经关节镜证实的膝关节OCD患者的术前MR图像,按照OCD国际软骨修复协会分类标准将OCD病变分成4级,与关节镜结果进行对照,计算MR评价OCD稳定性的特异度、敏感度和准确度,计算Kappa值,评价2名医师之间MR诊断OCD分级的一致性。计算提示膝关节OCD不稳定的MR征象诊断不稳定OCD的特异度、敏感度及准确度。结果 47例患者中,48个OCD病灶,Ⅰ、Ⅱ、Ⅲ、Ⅳ级OCD分别为4、8、16、20例,2名医师MR术前诊断OCD稳定性的特异度、敏感度、准确度分别为75.0%(83.3%)、88.9%(86.1%)、85.4%(85.4%),2名医师诊断OCD分级的一致性较好(Kappa=0.82)。提示膝关节OCD不稳定的MR征象:病灶与母体骨交界面线状高信号、病灶邻近骨质多发囊变影或出现大囊变(直径5 mm)、累及全层的软骨骨折线、累及全层的软骨缺损诊断膝关节OCD稳定性的特异度、敏感度、准确度分别为83.3%、80.6%、81.3%;75.0%、72.2%、72.9%;66.7%、69.4%、68.8%;100%、86.1%、89.6%。结论软骨缺损是诊断不稳定OCD最特异的MR征象,而软骨骨折线的准确率最低。膝关节MR检查是评价OCD稳定性及分级比较可靠的方法。
[Abstract]:Objective to evaluate the ability of (MR) to evaluate the (OCD) grading and stability of osteochondrositis of the knee. Methods the preoperative MR images of 47 cases of knee joint OCD confirmed by arthroscopy were analyzed retrospectively by two radiologists. According to the OCD International Association of cartilage Restoration Classification, the OCD lesions were classified into 4 grades and compared with the results of arthroscopy. The specificity, sensitivity and accuracy of MR in evaluating the stability of OCD were calculated. The Kappa value was calculated and the consistency of MR diagnostic OCD grading between two physicians was evaluated. The results showed that the specificity, sensitivity and accuracy of the MR signs of OCD instability in the diagnosis of unstable OCD. Results among the 47 patients, 48 OCD lesions (鈪，

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