MR Diagnosis of Posterior Root Tears of the Lateral Meniscus Using Arthroscopy as the Reference Standard
MR Diagnosis of Posterior Root Tears of the Lateral Meniscus Using Arthroscopy as the Reference Standard
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DOI：
10.2214/ajr.08.1300
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发表时间：
2009-02-01
影响因子：
5
通讯作者：
Shinki, Kazuhiko
中科院分区：
文献类型：
--
作者：
De Smet, Arthur A.;Blankenbaker, Donna G.;Shinki, Kazuhiko
OBJECTIVE.我们研究的目的是确定是否可以使用标准的MR标准的前交叉韧带（ACL）撕裂的存在或不存在的半月板撕裂诊断的外侧半月板后根的撕裂。从一系列559例膝关节MR检查与关节镜相关性中，我们选择了所有16例经证实的分离至外侧半月板后根的撕裂进行回顾性盲法审查，沿着45例关节镜下完整的外侧半月板后根。评审员根据三个特定的冠状位和三个特定的矢状位图像位置对牙根是否撕裂、可能撕裂或完整进行分类。当所有可能撕裂的牙根都被认为是撕裂时，诊断牙根撕裂的敏感性和特异性分别为93%和89%。观察者基于所有图像对撕裂的总体诊断给出了比基于三个冠状和三个矢状位置中的一个或任何组合的撕裂诊断更高的组合灵敏度和特异性。在ACL撕裂的情况下，根部撕裂明显更常见（p < 0.0001），但ACL撕裂的存在或不存在并不改变MR诊断的准确性。标准的MR标准，椎弓根变形和表面信号可用于诊断侧椎弓根撕裂。ACL撕裂的存在或不存在并不改变诊断的准确性。
OBJECTIVE. The purpose of our study was to determine whether tears of the posterior root of the lateral meniscus can be diagnosed using standard MR criteria of a meniscal tear in the presence or absence of an anterior cruciate ligament (ACL) tear.MATERIALS AND METHODS. From a series of 559 knee MR examinations with arthroscopic correlation, we selected all 16 proven tears isolated to the posterior root of the lateral meniscus for retrospective blinded review, along with 45 cases of arthroscopically intact lateral meniscal posterior roots. The reviewers categorized whether there was a torn, possibly torn, or intact root based on three specific coronal and three specific sagittal image locations.RESULTS. When all possibly torn roots were considered as torn, the sensitivity and specificity for diagnosis of a root tear were 93% and 89%, respectively. The observers' overall diagnosis of a tear based on all images gave a higher combined sensitivity and specificity than if the diagnosis of a tear had been based on one or any combination of the three coronal and three sagittal locations. Root tears were significantly more common in the presence of an ACL tear (p < 0.0001), but the presence or absence of an ACL tear did not change MR diagnostic accuracy.CONCLUSION. The standard MR criteria of meniscal distortion and signal to the surface can be used to diagnose lateral meniscal root tears. The presence or absence of an ACL tear did not change diagnostic accuracy.