Accuracy of 3-Tesla Magnetic Resonance Imaging for the Diagnosis of Intra-articular Knee Injuries in Children and Teenagers
Accuracy of 3-Tesla Magnetic Resonance Imaging for the Diagnosis of Intra-articular Knee Injuries in Children and Teenagers
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DOI：
10.1097/bpo.0b013e3182619181
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发表时间：
2012-12-01
影响因子：
1.7
通讯作者：
Saluan, Paul M.
中科院分区：
文献类型：
--
作者：
Schub, David L.;Altahawi, Faysal;Saluan, Paul M.
背景：磁共振成像（MRI）是诊断膝关节内病变的常用工具。虽然许多研究报告了MRI在成人人群中的准确性，但很少有研究在年轻患者中调查这些测试。此外，这些研究表明，在这个年龄组中，MRI对这些膝关节损伤的敏感性和特异性都有较高的变异性。MRI技术的进步，如3特斯拉（3 T）MRI磁体，已显示出对成人肌肉骨骼损伤诊断的良好结果。本研究的目的是评估3 T MRI的诊断关节内膝关节病变的儿童和青少年patient population.Methods：116例（119膝）的记录，年龄在20岁以下，谁进行了3 T MRI研究的膝盖和随后的膝关节镜进行了回顾性分析。比较了肌肉骨骼放射科工作人员的MRI报告、骨科医生的解释和手术记录口述，重点关注半月板和前交叉韧带（ACL）病理。17名骨科工作人员读数无法获得。结果：MRI检查时平均年龄为16.0岁，手术时平均年龄为16.2岁。使用肌肉骨骼放射学家的解释，3 T MRI对内侧半月板损伤的敏感性和特异性分别为81.0%和90.9%，对外侧半月板损伤的敏感性和特异性分别为68.8%和93%，对ACL损伤的敏感性和特异性分别为97.9%和98.6%。骨科医生对3 T MRI的解释对内侧半月板损伤的敏感性和特异性分别为75.7%和92.4%，对外侧半月板损伤的敏感性和特异性分别为69.8%和98.3%，对ACL损伤的敏感性和特异性分别为100%和98.6%。后角撕裂有最大的差异。结论：当对儿童和青少年患者进行，新的3 T MRI研究有很好的诊断ACL撕裂的准确性。这些研究还显示，内侧髋臼撕裂的诊断准确率高于外侧髋臼撕裂。证据等级：诊断性研究-2级。
Background: Magnetic resonance imaging (MRI) is a commonly used tool for the diagnosis of intra-articular knee pathologies. Although many studies have reported the accuracy of MRI in the adult population, fewer studies have investigated these tests in younger patients. Furthermore, these studies have shown a higher variability in both the sensitivity and the specificity of MRI for these knee injuries in this age group. Advancements in MRI technology, such as the 3-Tesla (3T) MRI magnet, have shown promising results for musculoskeletal injury diagnosis in adults. This study aims to evaluate 3 T MRI for the diagnosis of intra-articular knee pathologies in a pediatric and adolescent patient population.Methods: The records of 116 patients (119 knees) under the age of 20 years who underwent 3 T MRI studies of the knee and subsequent knee arthroscopy were reviewed retrospectively. The MRI report from the musculoskeletal radiology staff, the interpretation from the staff orthopedic surgeon, and the operative note dictations were compared, with a focus on meniscus and anterior cruciate ligament (ACL) pathologies. Seventeen orthopedic staff reads were not obtainable. Arthroscopy was used as the gold standard for diagnosis.Results: The average age at MRI exam was 16.0 years and at surgery was 16.2 years. Using the musculoskeletal radiologist interpretation, the sensitivity and the specificity of 3 T MRI were 81.0% and 90.9% for medial meniscus injuries, 68.8% and 93% for lateral meniscus injuries, and 97.9% and 98.6% for ACL injuries, respectively. The orthopedic surgeon's interpretation of 3 T MRI had a sensitivity and specificity of 75.7% and 92.4% for medial meniscus injuries, 69.8% and 98.3% for lateral meniscus injuries, and 100% and 98.6% for ACL injuries, respectively. Posterior horn tears had the greatest discrepancies.Conclusions: When performed on pediatric and adolescent patients, newer 3T MRI studies have excellent accuracy for diagnosing ACL tears. These studies also show a higher accuracy for the diagnosis of medial meniscal tears than lateral meniscal tears.Level of Evidence: Diagnostic study-Level 2.