张强军赵栓来



核磁共振诊断膝关节半月板损伤的可行性研究

张强军①赵栓来②

［摘要］目的：探讨膝关节半月板损伤的影像学变化，评估核磁共振成像（MRI）对其诊断的临床效果及可行性。方法：选取110例临床症状为膝关节半月板损伤的患者，按照随机数表法将其分为观察组与对照组，每组55例。观察组进行MRI检查，对照组进行常规CT检查，并均经手术或关节镜检查证实。根据两组患者的检查结果与手术或关节镜检查进行比较分析，评估MRI对膝关节半月板损伤的诊断价值。结果：采用MRI检查的观察组患者中，110例半月板MRI诊断内侧半月板损伤51处，外侧半月板损伤40处；I度损伤28例，II度损伤43例，Ⅲ度损伤20例；观察组与手术或关节镜检查比较无差异（t=0.416，t=0.323，t=0.121；P＞0.05）；对照组与手术或关节镜相比，膝关节损伤程度差异有统计学意义（Z=-2.491，P＜0.05）。结论：MRI可通过膝关节半月板的形态及信号改变判断其损伤程度，为临床诊断提供十分可靠的依据，具有较好的诊断价值。

［关键词］核磁共振；膝关节；半月板损伤；诊断；可行性

张强军，男，（1964- ），本科学历，副主任医师。商洛市第二人民医院CT和MRI室，从事影像诊断工作。

China Medical Equipment，2016，13（5）:61-63.

［Abstract］ Objective: This study focuses on the changes of the knee meniscus injury imaging to evaluate the clinical efficacy and feasibility of MRI in its diagnosis. Methods: A total of 110 cases of patients with knee meniscus injury in our hospital were selected and were randomly divided into two groups. The observation group was carried out MRI while the control group did routine CT examination. All were confirmed by surgery or arthroscopy. Evaluating the diagnostic value of MRI on the knee meniscus injury according to the comparative analysis based on examined results for the two groups. Results: In selecting a total of 55 patients， the knee meniscal injuries were unilateral， in which there were 51 medial meniscus injuries and 40 lateral meniscuses. There were 28 cases of the level 1 injuries， 43 cases of the secondary injury and 20 cases of the level 3 injuries. Therefore， there were no differences between the observation group and the surgery or arthroscopy examination（t=0.416， t=0.323， t=0.121； P＞0.05）. The analysis of the differences was statistically significant between the control group and the surgery or arthroscopy examination（Z=-2.491， P＜0.05）.

Conclusion: MRI can determine the extent of damage by morphological and signal changes of the knee meniscus. It can provide a very reliable basis for clinical diagnosis， which has high diagnostic value.

［First-author’s address］ Room for CT and MRI， The Second People’s Hospital， Shangluo， Shanxi， 726000， China.

膝关节是人体最大且构造最为复杂、最易发生损伤的关节之一，其中，内外侧半月板的损伤是导致膝关节疼痛及功能障碍的最常见原因之一［1］。然而，随着社会生活方式的变迁以及人们生活与运动习惯的改变，膝关节半月板损伤的发病率呈现逐年上升的趋势［2］。半月板的作用为稳定膝关节及促进关节内营养，从而确保膝关节经久的负重运动而不致损伤，若一旦损伤，将会由于半月板的损伤游离缘缺乏血液供应而难于愈合完善［3］。……