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目的探讨MRI冠状面形态学指标评成人完全型价外侧盘状半月板损伤的能力。方法回顾性分析具有术前完整MRI影像资料并经关节镜手术证实的成人完全型外侧盘状半月板病例115膝。采用“外侧盘状半月板体部宽度与股骨外侧髁宽度比值以及外侧盘状半月板游离缘高度与其中部高度的比值”两个MRI冠状面形态学指标作为评价外侧盘状半月板损伤的指标。以膝关节镜检查结果作为诊断金标准,分别计算孤立形态学指标以及联合形态学指标评价外侧盘状半月板损伤的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率。结果 (1)仅依据外侧盘状半月板体部宽度与股骨外髁宽度比值诊断成人完全型外侧盘状半月板损伤的敏感性为46.1%,特异性为94.9%,阳性预测值为93.8%,阴性预测值为44.6%,准确性为58.3%;(2)仅依据外侧盘状半月板游离缘高度与其中部高度比值诊断的敏感性性39.5%,特异性为94.9%,阳性预测值为93.8%,阴性预测值为44.6%,准确性为58.3%;(3)联合应两个形态学指标总的敏感性为85.5%,特异性为92.3%,阳性预测值为95.4%,阴性预测值为76.6%,准确性为87.8%。结论采用孤立冠状面形态学指标单独评价外侧盘状半月板损伤的特异性较好,但敏感性偏低;而联合应用多个冠状面形态学指标可以获得较高的敏感性和特异性。MRI冠状面形态学指标在成人完全型外侧盘状半月板损伤的MRI评价中具有重要价值。
Objective To investigate the ability of MRI coronal morphology to evaluate the complete prosthetic lateral discoid meniscus injury. Methods One hundred and fifteen knees of adult complete discoid meniscus were analyzed retrospectively with complete preoperative MRI data and confirmed by arthroscopy. The ratio of the “ratio of the width of the lateral discoid meniscus to the lateral femoral condyle and the ratio of the height of the free edge of the lateral discoid meniscus to the height of the middle” were used to evaluate the morphological changes of the lateral discoid meniscus index. The results of knee arthroscopy as the gold standard for diagnosis, respectively, calculate the sensitivity of the isolated morphological indicators and combined morphological evaluation of discoid meniscus injury, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results (1) The sensitivity, specificity and accuracy of the diagnosis were only 46.1%, 94.9% and 93.8%, respectively, based on the ratio of the width of the lateral discoid meniscus and the width of the lateral femoral condyle in diagnosis of adult complete discoid meniscus injury. The negative predictive value was 44.6% and the accuracy was 58.3%. (2) The sensitivity, specificity and accuracy of diagnosis were only 39.5%, 94.9% and 93.8%, respectively, based on the ratio of the height of the free edge of the lateral discoid meniscus to the height of the middle part. , The negative predictive value was 44.6% and the accuracy was 58.3%. (3) The combined sensitivity of the two morphological indicators was 85.5%, the specificity was 92.3%, the positive predictive value was 95.4% and the negative predictive value was 76.6 %, The accuracy is 87.8%. Conclusions It is better to use isolated coronal morphology to evaluate the specificity of the lateral discoid meniscus injury, but the sensitivity is low. However, the combined use of multiple coronal morphological indexes can obtain higher sensitivity and specificity. MRI coronal morphology is of great value in the MRI evaluation of adult complete discoid meniscus injury.