Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology
Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology
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DOI：
10.1007/s00167-014-3395-5
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发表时间：
2015-01-01
影响因子：
3.8
通讯作者：
Matheny, Lauren M.
中科院分区：
文献类型：
--
作者：
LaPrade, Robert F.;Ho, Charles P.;Matheny, Lauren M.
本研究的目的是确定 3 T MRI 在检测后内侧和外侧半月板根部撕裂和撕脱方面的诊断准确性，包括敏感性、特异性、阴性和阳性预测值。所有接受膝关节 3 T MRI 并随后进行关节镜手术的患者均纳入本研究。关节镜检查被认为是金标准。通过关节镜检查和 MRI 诊断的半月板根部撕裂被定义为距根部 9 毫米以内的完全半月板根部脱离。所有手术数据均前瞻性收集并存储在数据注册表中。 MRI 检查由肌肉骨骼放射科医生前瞻性报告并进行回顾性审查。本研究共有 287 名连续患者（156 名男性，131 名女性；平均年龄 41.7 岁）。关节镜检查发现半月板后根撕裂的发生率为 9.1%，内侧半月板后根撕裂为 5.9%，侧根撕裂为 3.5%（一名患者同时存在两种情况）。敏感性为 0.770 (95% CI 0.570, 0.901)，特异性为 0.729 (95% CI 0.708, 0.741)，阳性预测值为 0.220 (95% CI 0.163, 0.257)，阴性预测值为 0.970 (95% CI 0.943, 0.943)。 0.987）。对于内侧根撕裂，敏感性为 0.824 (95% CI 0.569, 0.953)，特异性为 0.800 (95% CI 0.784, 0.808)，阳性预测值为 0.206 (95% CI 0.142, 0.238)，阴性预测值为 0.986 (95% CI) 0.967、0.996）。对于外侧半月板后根撕裂，敏感性为 0.600 (95% CI 0.281, 0.860)，特异性为 0.903 (95% CI 0.891, 0.912)，阳性预测值为 0.181 (95% CI 0.085, 0.261)，阴性预测值为 0.984 (95% CI) 0.972, 0.994)。本研究证明 3 T MRI 检测后半月板根部撕裂具有中等敏感性和特异性。 3T MRI检测后半月板根部撕裂的阴性预测值较高；然而，阳性预测值较低。内根撕裂的敏感性较高，表明 MRI 遗漏侧根撕裂的风险较高。影像学检查对于识别半月板后角根部撕裂具有重要作用；然而，某些牙根撕裂可能要通过关节镜检查才能发现。预后研究（诊断），II 级。
The purpose of this study was to determine the diagnostic accuracy of 3 T MRI, including sensitivity, specificity, negative and positive predictive values, for detection of posterior medial and lateral meniscus root tears and avulsions.All patients who had a 3 T MRI of the knee, followed by arthroscopic surgery, were included in this study. Arthroscopy was considered the gold standard. Meniscus root tears diagnosed at arthroscopy and on MRI were defined as a complete meniscus root detachment within 9 mm of the root. All surgical data were collected prospectively and stored in a data registry. MRI exams were reported prospectively by a musculoskeletal radiologist and reviewed retrospectively.There were 287 consecutive patients (156 males, 131 females; mean age 41.7 years) in this study. Prevalence of meniscus posterior root tears identified at arthroscopy was 9.1, 5.9 % for medial and 3.5 % for lateral root tears (one patient had both). Sensitivity was 0.770 (95 % CI 0.570, 0.901), specificity was 0.729 (95 % CI 0.708, 0.741), positive predictive value was 0.220 (95 % CI 0.163, 0.257) and negative predictive value was 0.970 (95 % CI 0.943, 0.987). For medial root tears, sensitivity was 0.824 (95 % CI 0.569, 0.953), specificity was 0.800 (95 % CI 0.784, 0.808), positive predictive value was 0.206 (95 % CI 0.142, 0.238) and negative predictive value was 0.986 (95 % CI 0.967, 0.996). For lateral meniscus posterior root tears, sensitivity was 0.600 (95 % CI 0.281, 0.860), specificity was 0.903 (95 % CI 0.891, 0.912), positive predictive value was 0.181 (95 % CI 0.085, 0.261) and negative predictive value was 0.984 (95 % CI 0.972, 0.994).This study demonstrated moderate sensitivity and specificity of 3 T MRI to detect posterior meniscus root tears. The negative predictive value of 3 T MRI to detect posterior meniscus root tears was high; however, the positive predictive value was low. Sensitivity was higher for medial root tears, indicating a higher risk of missing lateral root tears on MRI. Imaging has an important role in identifying meniscus posterior horn root tears; however, some root tears may not be identified until arthroscopy.Prognostic study (diagnostic), Level II.