CAJ | 학술논문

目的：研究膝关节内侧半月板后角根部撕裂在MRI不同扫描方位的诊断价值。方法收集我院经MRI检查，并经关节镜证实的32例内侧半月板后角根部撕裂资料进行分析；选取32例同年龄段的半月板其他节段损伤而无根部撕裂资料组进行对照。病例组分别在矢、冠、轴位图像上观察各扫描方位撕裂特征性征象，统计各扫描方位诊断的敏感性，特异性，阳性预测值和阴性预测值。结果32例内侧半月板后角根部撕裂中，矢状位上主要表现为“鬼影征”；冠状位主要表现为“截断征”，具体各表现略有不同；轴位上主要表现为“钝圆征”或“裂隙征”。上述征象在病灶组均明显好发于对照组（P＜0.05）。敏感性，特异性，阳性预测值和阴性预测值在病例组矢状位观察分别为：100%、80%、80%和100%；冠状位上分别为：100%、95%、93.8%和100%；轴位上为：93.8%、90.7%、90.9%和93.5%。结论 MRI扫描矢、冠、轴三个方位显示内侧半月板后角根部撕裂各有其特征性征象，明显好发于对照组。根部撕裂矢状位诊断的敏感性非常高，但会出现假阳性现象；冠状位敏感性同样非常高，而且诊断特异性优于矢状位；轴位图像是显示内侧半月板根部撕裂的容积形态的最好方位，但诊断价值受限于扫描到的半月板层数太少。
목적：연구슬관절내측반월판후각근부시렬재MRI불동소묘방위적진단개치。방법수집아원경MRI검사，병경관절경증실적32례내측반월판후각근부시렬자료진행분석；선취32례동년령단적반월판기타절단손상이무근부시렬자료조진행대조。병례조분별재시、관、축위도상상관찰각소묘방위시렬특정성정상，통계각소묘방위진단적민감성，특이성，양성예측치화음성예측치。결과32례내측반월판후각근부시렬중，시상위상주요표현위“귀영정”；관상위주요표현위“절단정”，구체각표현략유불동；축위상주요표현위“둔원정”혹“렬극정”。상술정상재병조조균명현호발우대조조（P＜0.05）。민감성，특이성，양성예측치화음성예측치재병례조시상위관찰분별위：100%、80%、80%화100%；관상위상분별위：100%、95%、93.8%화100%；축위상위：93.8%、90.7%、90.9%화93.5%。결론 MRI소묘시、관、축삼개방위현시내측반월판후각근부시렬각유기특정성정상，명현호발우대조조。근부시렬시상위진단적민감성비상고，단회출현가양성현상；관상위민감성동양비상고，이차진단특이성우우시상위；축위도상시현시내측반월판근부시렬적용적형태적최호방위，단진단개치수한우소묘도적반월판층수태소。
Objective To study the diagnosing value of various scanning planes of MRI in medial meniscal root tear. Methods MRI of 32 patients with arthroscopically confirmed posterior medial meniscal root tear was compared to that of 32 age-matched patients with medial meniscal tear not involving the root.The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of root tear were calculated for sagittal,coronal,and axial planes.Results The characteristic“ghost”sign on sagittal,“truncation”sign on coronal,and“blunted”or“cleft”sign on axial MRI were significantly(P<0.05)more common in root tear than meniscal tear not involving the root.On the sagittal,coronal and axial MRI,the sensitivities were 100%,100%, 93.8%;specificities were 80.0%,95.0%,90.7%;positive predictive values were 80%,93.8%,90.9%;and negative predictive values were 100%,100%,93.5%,respectively.Conclusion The MRI findings of medial meniscal root tear are characteristic in various scanning planes with high sensitivity in the sagittal and coronal planes,and highest specificity in the coronal plane.The axial plane is best for demonstrating the morphology of the tear with limitation of few slices depicting the menisci.