磁共振成像是一种有效的一线无创半月板撕裂检测工具：与膝关节镜回顾性比较分析

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.asmr.2024.101065

Ahmed Mohsen Abbas El-Hagrasy M.B., B.Ch., B.A.O. , Aaron Jijimon Theckayil M.B., B.Ch., B.A.O. , Mohammad Adeel Khan M.B.B.S., M.R.C.S. , Hammad Naqi Khan M.B.B.S., F.C.P.S. , Ahsan Javaid Butt M.B.B.S., F.R.C.S., Tr.&Orth.

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引用次数: 0

摘要

目的评价和比较磁共振成像（MRI）与术中膝关节镜检查对半月板撕裂的诊断准确性。方法：我们对在同一所大学医院接受MRI和膝关节镜检查显示内侧半月板（MM）或外侧半月板（LM）撕裂的患者进行了回顾性研究。将患者术前MRI检查结果与术中关节镜检查结果进行比较，以确定半月板撕裂的存在、位置和形态。关节镜检查结果被认为是最终诊断。结果初步确定543例患者。其中220人符合研究资格标准并被纳入研究。MRI对关节镜检查的敏感性、特异性和准确性分别为MM撕裂的94.29%（95%可信区间[CI]， 89.05% ~ 97.50%）、78.75% （95% CI, 68.17% ~ 87.11%）和88.64% (95% CI, 83.68% ~ 92.51%)， LM撕裂的敏感性、特异性和准确性分别为76.74% （95% CI, 66.39% ~ 85.18%）、94.03% （95% CI, 88.58% ~ 97.39%）和87.27% （95% CI, 82.13% ~ 91.37%）。复合撕裂是最常见的撕裂形态，后角是最常见的位置。结论smri是一种有效的半月板撕裂的一线无创诊断工具，MM撕裂的总体诊断准确率为88.64%，LM撕裂的总体诊断准确率为87.27%。MM撕裂发生率最高，尤其在后角。MRI对MM撕裂具有高敏感性，对LM撕裂具有高特异性，在诊断MM和LM撕裂方面与关节镜基本一致。然而，MRI对MM撕裂的特异性和LM撕裂的敏感性较低，提示其在确认MM撕裂或排除LM撕裂方面可能不那么可靠。证据水平：III级，回顾性队列研究。

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Magnetic Resonance Imaging Is an Effective First-Line Noninvasive Tool for Meniscal Tear Detection: A Retrospective Comparative Analysis With Knee Arthroscopy

Purpose

To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI) with intraoperative knee arthroscopic findings for identifying or diagnosing meniscal tears.

Methods

We conducted a retrospective study of patients who underwent MRI and knee arthroscopy showing either medial meniscus (MM) or lateral meniscus (LM) tears at a single university hospital. The preoperative MRI findings of patients were compared with intraoperative arthroscopic findings to determine the presence, location, and morphology of meniscal tears. The results of arthroscopy were considered the definitive diagnosis.

Results

A total of 543 patients were initially identified. Of these, 220 met the study eligibility criteria and were included. The sensitivity, specificity, and accuracy of MRI in relation to arthroscopy were 94.29% (95% confidence interval [CI], 89.05%-97.50%), 78.75% (95% CI, 68.17%-87.11%), and 88.64% (95% CI, 83.68%-92.51%), respectively, for MM tears and 76.74% (95% CI, 66.39%-85.18%), 94.03% (95% CI, 88.58%-97.39%), and 87.27% (95% CI, 82.13%-91.37%), respectively, for LM tears. Complex tears were the most common morphology of tears, and the posterior horn was the most common location.

Conclusions

MRI is an effective first-line noninvasive diagnostic tool for investigating meniscal tears, with overall diagnostic accuracies of 88.64% for MM tears and 87.27% for LM tears. MM tears had the highest incidence, particularly in the posterior horn. MRI showed high sensitivity for MM tears, high specificity for LM tears, and substantial agreement with arthroscopy in diagnosing both MM and LM tears. However, MRI’s specificity for MM tears and sensitivity for LM tears were lower, suggesting that it may not be as reliable in confirming MM tears or ruling out LM tears.