A comparison of accuracy between clinical examination and magnetic resonance imaging in the diagnosis of meniscal and anterior cruciate ligament tears
A comparison of accuracy between clinical examination and magnetic resonance imaging in the diagnosis of meniscal and anterior cruciate ligament tears
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DOI：
10.1016/s0749-8063(96)90032-8
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发表时间：
1996-08-01
期刊：
影响因子：
4.7
通讯作者：
Gold, SM
中科院分区：
文献类型：
--
作者：
Rose, NE;Gold, SM
我们进行了一项前瞻性和回顾性研究，比较磁共振成像（MRI）与临床检查诊断半月板和前交叉韧带（ACL）撕裂的准确性。病理结果在关节镜检查中得到证实，154名临床诊断为半月板或前交叉韧带撕裂的患者最终接受了关节镜手术；100例患者行临床检查后行MRI检查，54例患者单独行临床检查。在关节镜检查中确认半月板和前交叉韧带撕裂的存在与否，对100例同时接受临床检查和MRI检查的患者进行临床检查和MRI检查的准确性进行比较。内侧半月板撕裂的MRI准确率为75%，外侧半月板撕裂的准确率为69%，前交叉韧带撕裂的准确率为98%。内侧半月板撕裂的临床检查准确率为82%，外侧半月板撕裂为76%，前交叉韧带完全撕裂为99%。此外，54例单独接受临床检查的患者的临床检查准确性与100例同时接受MRI检查的患者的临床检查准确性无显著差异。在半月板和前交叉韧带撕裂的诊断方面，临床检查和MRI的准确性没有显著差异，总体而言，MRI在100例病例中只有16例有助于治疗。基于这些发现，我们认为MRI，除了在某些情况下，是一个昂贵的和不必要的诊断测试，患者怀疑半月板和前交叉韧带病理。
A prospective and retrospective study was undertaken to compare the accuracy of magnetic resonance imaging (MRI) with clinical examination in diagnosing meniscal and anterior cruciate ligament (ACL) tears. Pathological findings were then confirmed during arthroscopy, One hundred fifty-four patients clinically diagnosed with a meniscal or ACL tear who ultimately had arthroscopic knee surgery were evaluated; 100 patients underwent clinical examination followed by MRI, and 54 underwent clinical examination alone. The presence or absence of meniscal and ACL tears was confirmed during arthroscopy, The accuracies of clinical examination and MRI were compared for the 100 patients who underwent both clinical examination and MRI. The accuracy of MRI was 75% for medial meniscal tears, 69% for lateral meniscal tears and 98% for ACL tears. The accuracy of clinical examination was 82% for medial meniscal tears, 76% for lateral meniscal tears and 99% for complete tears of the ACL. Furthermore, the accuracy of clinical examination for the 54 patients who underwent clinical examination alone was not significantly different from the accuracy of clinical examination in the 100 patients who also underwent MRI. There was no significant difference between the accuracy of clinical examination and MRI in the diagnosis of meniscal and ACL tears and, overall, MRI contributed to treatment in only 16 of 100 cases. Based on these findings, we feel that MRI, except in certain circumstances, is an expensive and unnecessary diagnostic test in patients with suspected meniscal and ACL pathology.