梅毅军

[摘要] 目的 探讨分析磁共振在诊断交叉韧带损伤中的临床应用价值。方法 随机选取该院2018年10月—2019年10月收治的70例交叉韧带损伤患者为研究对象，均分别采用X线片和磁共振进行检查，比较两种方法的诊断结果及其相关指标。结果 与术后病理分析结果相比较，磁共振诊断结果的准确率为94.29%，明显高于X线的70.00%，两组比较差异有统计学意义（χ2=14.073，P=0.000<0.05）;磁共振诊断前交叉韧带受损者为40例，胫骨轻度前移者为6例，有20例为后交叉韧带损伤;X线诊断前交叉韧带受损者为33例，后交叉韧带损伤为16例。磁共振成像的阳性检出率为71.43%（50/70），X线的阳性检出率为47.14%，磁共振诊断的准确率、敏感度、特异度均明显高于X线，差异有统计学意义（χ2=14.073，P=0.000<0.05;χ2=4.443，P=0.035<0.05;χ2=4.435，P=0.035<0.05）。在磁共振診断40例前交叉韧带损伤患者中，前交叉韧带中段损伤7例，前交叉韧带下段损伤13例，前交叉韧带中上段损伤20例。MRI征象以韧带增粗为主要表现，韧带完全撕裂的MRI征象为：韧带出现增粗、肿胀、断裂等征象，韧带边界不清、断端信号增高，T2WI 信号显示韧带伴有假团块及回缩征象。结论 采用磁共振技术诊断交叉韧带损伤具有较高的准确性和临床应用价值。

[关键词] 磁共振;X线片;交叉韧带损伤

[中图分类号] R445          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0181-03

The Clinical Value of MRI Diagnosis of Cruciate Ligament Injury

MEI Yi-jun

Department of Medical Imaging， Affiliated Hospital of Soochow University， Changshu First People's Hospital， Changshu， Jiangsu Province， 215500 China

[Abstract] Objective To explore the clinical application value of magnetic resonance in the diagnosis of cruciate ligament injury. Methods The patients about 70 case with cruciate ligament injuries admitted in the hospital from October 2018 to October 2019 were randomly selected and studied by X-ray and magnetic resonance imaging， respectively. The diagnostic results and related indexes of the two methods were compared. Results Compared with the results of postoperative pathological analysis， the accuracy of the magnetic resonance diagnosis was 94.29%， which was significantly higher than 70.00% of the X-ray，the difference was statistically significant （χ2=14.073，P=0.000<0.05）; 40 cases had anterior cruciate ligament damage diagnosed by MRI， 6 cases had mild tibial advancement， and 20 cases had posterior cruciate ligament injury; 33 cases had anterior cruciate ligament diagnosis by X-ray diagnosis. There were 16 cases of posterior cruciate ligament injury. The positive detection rate of magnetic resonance imaging was 71.43% （50/70）， and the positive detection rate of X-rays was 47.14%. The accuracy， sensitivity， and specificity of magnetic resonance imaging were significantly higher than those of X-rays，the difference was statistically significant （χ2=14.073，P=0.000<0.05;χ2=4.443，P=0.035<0.05;χ2=4.435，P=0.035<0.05）. Among 40 patients with anterior cruciate ligament injury diagnosed by magnetic resonance， 7 cases were injured in the middle part of the ACL， 13 cases were injured in the lower part of the ACL， and 20 cases were injured in the upper part of the ACL. MRI signs are mainly characterized by thickening of the ligament. MRI signs of complete tearing of the ligament are： signs of thickening， swelling， and rupture of the ligament， unclear ligament boundaries， increased signal at the stump， and T2WI signals showing the ligament with false clumps and retraction signs. Conclusion The diagnosis of cruciate ligament injury with magnetic resonance technology has high accuracy and clinical application value.

[Key words] Magnetic resonance; X-ray film; Cruciate ligament injury

交叉韧带损伤主要是指膝关节十字韧带出现撕裂或断裂，临床表现为不同程度的肢体疼痛、血肿和活动功能受限等症状，如果未能及时明确诊断及有效治疗，可导致关节反复扭伤、半月板损害、关节旋转不稳等后遗症，会严重影响到患者身体健康和生活质量[1]。目前，临床上大多采用X线片、关节镜、磁共振等影像学检查进行诊断，由于绝大多数患者在损伤后会出现程度不同的肿胀，以及检查方式所存在的局限性，因此对诊断正确率产生一定程度的影响[2]。该文通过对该院2018年10月—2019年10月收治的70例交叉韧带损伤患者相关临床资料的回顾性分析，探讨磁共振在诊断交叉韧带损伤中的临床应用价值，报道如下。

1  资料与方法

1.1  一般资料

随机选取该院收治的交叉韧带损伤患者70例作为该次研究的对象，均分别接受X线和磁共振检查。纳入标准：均伴有不同程度關节肿胀、疼痛、关节不稳等症状;均自愿参加该次研究并签署知情同意书。排除标准：有其他膝关节病史;膝关节手术史;骨囊肿等骨性病变史;合并患有严重脏器损伤及恶性肿瘤;有化脓性关节炎和类风湿性关节炎;有凝血功能障碍。……