CAJ | 학술논문

背景:常规磁共振检查可较为全面地显示关节内软组织的结构,但由于其成像后对比度欠缺等因素,在诊断关节内病变和损伤时仍存在一定的局限性.为了提高诊断的准确率,磁共振的增强扫描已应用于肝脏、脑等其他部位,但有关膝关节增强扫描的报道较少.目的:评价磁共振关节内增强扫描对膝关节损伤诊断的临床应用价值.方法:选择21例膝关节损伤患者(22膝),采用美国GE公司生产的0.5T Signa Contour磁共振扫描仪先进行常规磁共振扫描.常规扫描完成后,向关节内注入增强剂,行关节内增强扫描.所有病例均由同一医师进行关节内增强操作,由两名副主任职称以上的医师进行阅片分析和对比.结果与结论:所有病例在平扫中均发现有不同程度的关节结构损伤,包括骨质、半月板、韧带和关节软骨等.在磁共振增强扫描后进一步证实,其损伤的程度和范围上得到了更清楚的显示.同时,有2例平扫中误诊的半月板损伤,在增强扫描后得到否定;有的损伤部位在平扫中未发现的病变信号,在关节内增强扫描中被发现和证实.说明增强后磁共振扫描膝关节损伤的阳性率高于常规扫描.其中,增强前后半月板损伤诊断准确率差异有显著性意义(P=0.035).提示,与常规扫描相比,磁共振关节内增强扫描可进一步提高膝关节损伤的诊断率.
배경:상규자공진검사가교위전면지현시관절내연조직적결구,단유우기성상후대비도흠결등인소,재진단관절내병변화손상시잉존재일정적국한성.위료제고진단적준학솔,자공진적증강소묘이응용우간장、뇌등기타부위,단유관슬관절증강소묘적보도교소.목적:평개자공진관절내증강소묘대슬관절손상진단적림상응용개치.방법:선택21례슬관절손상환자(22슬),채용미국GE공사생산적0.5T Signa Contour자공진소묘의선진행상규자공진소묘.상규소묘완성후,향관절내주입증강제,행관절내증강소묘.소유병례균유동일의사진행관절내증강조작,유량명부주임직칭이상적의사진행열편분석화대비.결과여결론:소유병례재평소중균발현유불동정도적관절결구손상,포괄골질、반월판、인대화관절연골등.재자공진증강소묘후진일보증실,기손상적정도화범위상득도료경청초적현시.동시,유2례평소중오진적반월판손상,재증강소묘후득도부정;유적손상부위재평소중미발현적병변신호,재관절내증강소묘중피발현화증실.설명증강후자공진소묘슬관절손상적양성솔고우상규소묘.기중,증강전후반월판손상진단준학솔차이유현저성의의(P=0.035).제시,여상규소묘상비,자공진관절내증강소묘가진일보제고슬관절손상적진단솔.
BACKGROUND: Routine magnetic resonance imaging(MRI)scans can comparatively show intra-articular soft tissue structures,but there are still some limitations in the diagnosis of intra-articular lesions and injury due to deficiency in contrast of imaging.Enhanced MRI scan has been applied to the liver,brain and other parts,which effectively improves the diagnostic accuracy,but there are few reports on the enhanced scans of knee.OBJECTIVE: To evaluate clinical application value of MRI enhancement pattern in diagnosis of knee injury.METHODS: Totally 21 patients with knee injury(22 knees)were routinely scanned by 0.5T Signa Contour MRI scanner(GE company,USA).Then enhancer was injected into knee joint by the same physician and MRI enhancement pattern was performed in these patients.Film-reading and comparison were completed by two associate chief physicians.RESULTS AND CONCLUSION: Different levels of joint structural damage,such as bone,meniscus,ligaments,and articular cartilage and so on,were found in all patients by routine MRI scan.The extent and scope of its damage had been more clearly displayed by enhanced MRI scan.Meanwhile,misdiagnosis of meniscal injury by routine MRI scan was confirmed by enhanced MRI scan in 2 patients.Some damaged parts that were not found by routine MRI scan were Confirmed by enhanced MRI scan.All these demonstrated that positive rate of knee injury in MRI enhancement pattern was higher than conventional MRI scan.There was significant difference in meniscus injury between two patterns(P = 0.035).MRI enhancement pattern in comparison with conventional MRI can further improve the diagnostic accuracy rate of knee injury.