Comparison of knee SPECT and MRI in evaluating meniscus injuries in soldiers.
Comparison of knee SPECT and MRI in evaluating meniscus injuries in soldiers.
复制标题
膝关节 SPECT 和 MRI 评估士兵半月板损伤的比较。
DOI：
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
A. Finestone
中科院分区：
文献类型：
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作者：
Maya Wertman;C. Milgrom;G. Agar;Y. Milgrom;Newton Yalom;A. Finestone
背景
对疑似半月板损伤的医学评估始于病史采集和体格检查。对治疗无效的疑似半月板损伤通常在关节镜检查前进行影像学检查以确诊。在评估疑似膝关节半月板撕裂时，建议将Tc-MDP骨单光子发射计算机断层扫描（SPECT）作为磁共振成像（MRI）的替代方法。
目标
与关节镜金标准相比，检查膝关节SPECT作为识别半月板撕裂工具与MRI的准确性。
方法
检索以色列国防军数据库2005年至2009年的关键词：膝关节MRI，膝关节SPECT和膝关节镜检查。我们确定了330名受试者，他们在膝关节手术前接受了单膝SPECT和单膝MRI检查。随机抽取330例受试者中193例的病历进行审查。比较术前SPECT和MRI研究与关节镜检查结果。计算敏感性、特异性和准确性。
结果
受试者的年龄为21.3 ± 3.9岁。SPECT与关节镜检查的一致性分别为内侧半月板0.14和外侧半月板0.29。MRI和关节镜检查的一致性分别为内侧半月板0.59和外侧半月板0.69。发现SPECT扫描在检测常见膝关节病变方面的敏感性为61%，特异性为54%，准确性为58%，而MRI的敏感性为95%，特异性为67%，准确性为85%。
结论
膝关节SPECT在评估关节损伤方面的敏感性、特异性和准确性低于MRI，并且其使用可能导致不必要的手术增加。
BACKGROUND
Medical evaluation of a suspected meniscus injury begins with a history-taking and physical examination. Suspected meniscus injuries not responding to treatment are usually sent for imaging to confirm the diagnosis before arthroscopy. Tc-MDP bone single photon emission computed tomography (SPECT) scan has been suggested as an alternative to magnetic resonance imaging (MRI) in evaluating suspected knee meniscus tears.
OBJECTIVES
To examine the accuracy of knee SPECT as a tool to identify meniscus tears versus that of MRI as compared to the gold standard of arthroscopy.
METHODS
The Israel Defense Forces database for 2005 through 2009 was searched using the key words: knee MRI, knee SPECT and knee arthroscopy. We identified 330 subjects who had undergone both a single knee SPECT and a single knee MRI prior to knee surgery. The medical files of 193 of the 330 subjects were randomly selected for review. A comparison was made between the preoperative SPECT and MRI studies and the arthroscopic finding. The sensitivity, specificity and accuracy were calculated.
RESULTS
The subjects' age was 21.3 ± 3.9. The agreement between SPECT and arthroscopy was 0.14 forthe medial meniscus and 0.29 for the lateral meniscus. The agreement between MRI and arthroscopy was 0.59 for the medial meniscus and 0.69 for the lateral meniscus. SPECT scan was found to be 61% sensitive, 54% specific and 58% accurate in detecting common knee pathology, whereas MRI was found to be 95% sensitive, 67% specific and 85% accurate.
CONCLUSIONS
Knee SPECT has a lower sensitivity, specificity and accuracy than MRI in evaluating meniscal injuries and its use can result in increased unnecessary surgery.
DOI：
10.1001/jama.286.13.1610
发表时间：
2001
期刊：
JAMA
影响因子：
--
作者：
Solomon,DH;Simel,DL;Bates,DW;Katz,JN;Schaffer,JL
通讯作者：
Schaffer,JL