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[1]沈雯,李廣軍,張峭巍.MRI診斷前交叉韌帶斷裂合并Ramp損傷的價值及前交叉韌帶斷裂合并Ramp損傷的發(fā)病特征分析…[J].中醫(yī)正骨,2022,34(01):28-32.
　SHEN Wen,LI Guangjun,ZHANG Qiaowei.Value of MRI in diagnosis of anterior cruciate ligament rupture combined with Ramp lesions and analysis of its onset characteristics[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(01):28-32.
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MRI診斷前交叉韌帶斷裂合并Ramp損傷的價值及前交叉韌帶斷裂合并Ramp損傷的發(fā)病特征分析…()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年01期
頁碼:
28-32
欄目:
臨床研究
出版日期:
2022-01-20

文章信息/Info

Title:
Value of MRI in diagnosis of anterior cruciate ligament rupture combined with Ramp lesions and analysis of its onset characteristics
作者:
沈雯1; 李廣軍1; 張峭巍2
(1.德清縣人民醫(yī)院,浙江 德清 313299; 2.浙江大學醫(yī)學院附屬邵逸夫醫(yī)院,浙江 杭州 310016)
Author(s):
SHEN Wen1; LI Guangjun1; ZHANG Qiaowei2
1.Deqing People’s Hospital,Deqing 313299,Zhejiang,China;2.Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,Zhejiang,China
關鍵詞:
膝關節(jié);  前交叉韌帶損傷;  Ramp損傷;  磁共振成像;  關節(jié)鏡檢查
Keywords:
knee joint;  anterior cruciate ligament injuries;  Ramp injuries;  magnetic resonance imaging;  arthroscopy
摘要:
目的:探討MRI診斷前交叉韌帶(anterior cruciate ligament,ACL)斷裂合并Ramp損傷的價值,分析ACL斷裂合并Ramp損傷的發(fā)病特征。方法:回顧性分析術前行膝關節(jié)MRI檢查并采用關節(jié)鏡ACL重建術治療的ACL斷裂患者的病例資料,由2名具有5年以上工作經(jīng)驗的影像專業(yè)醫(yī)師分析MRI結果,診斷是否合并Ramp損傷,與關節(jié)鏡下確診結果比較,計算MRI診斷ACL斷裂合并Ramp損傷的敏感度、特異度、陽性預測值、陰性預測值、約登指數(shù)和優(yōu)勢比。根據(jù)關節(jié)鏡下確診結果將納入患者分為合并Ramp損傷組和不合并Ramp損傷組,比較2組患者的性別、年齡、ACL斷裂類型、ACL斷裂程度及后交叉韌帶損傷、脛骨后外側骨挫傷、脛骨后內(nèi)側骨挫傷、內(nèi)側副韌帶損傷、外側副韌帶損傷、內(nèi)側半月板損傷、外側半月板損傷情況,分析ACL斷裂合并Ramp損傷的發(fā)病特征。結果:共納入463例患者的病例資料,MRI診斷ACL斷裂合并Ramp損傷40例,其中假陽性2例; 關節(jié)鏡下確診ACL斷裂合并Ramp損傷78例。2名醫(yī)師的診斷結果一致性一般(Kappa=0.598)。MRI診斷ACL斷裂合并Ramp損傷的敏感度為48.7%、特異度為99.5%、陽性預測值為95.0%、陰性預測值為90.5%、約登指數(shù)為48.2%、優(yōu)勢比為181.925。合并Ramp損傷組納入78例,不合并Ramp損傷組納入385例。合并Ramp損傷組患者ACL慢性斷裂、合并脛骨后內(nèi)側骨挫傷的發(fā)生率均高于不合并Ramp損傷組(χ2=10.179,P=0.001; χ2=7.507,P=0.006); 2組患者性別、年齡、ACL斷裂程度及后交叉韌帶損傷、脛骨后外側骨挫傷、內(nèi)側副韌帶損傷、外側副韌帶損傷、內(nèi)側半月板損傷、外側半月板損傷情況比較,組間差異均無統(tǒng)計學意義(χ2=0.852,P=0.356; χ2=2.680,P=0.444; χ2=3.296,P=0.069; χ2=0.005,P=0.943; χ2=2.143,P=0.143; χ2=2.276,P=0.131; χ2=3.008,P=0.083; χ2=3.087,P=0.079; χ2=3.001,P=0.083)。結論:MRI診斷ACL斷裂合并Ramp損傷具有一定的應用價值,ACL斷裂合并Ramp損傷的發(fā)病特征包括ACL慢性斷裂和合并脛骨后內(nèi)側骨挫傷。
Abstract:
Objective:To explore the value of magnetic resonance imaging(MRI)in diagnosis of anterior cruciate ligament(ACL)rupture combined with Ramp lesions,and to analyze its onset characteristics.Methods:The medical records of patients who received knee MRI examination and underwent arthroscopic ACL reconstruction for ACL rupture were analyzed retrospectively.The MRI outcomes were analyzed by 2 imaging specialists with more than five years work experience to confirm whether the Ramp lesions were present,followed by the comparison with the arthroscopic diagnosis results,and then the sensitivity,specificity,positive predictive value,negative predictive value,Youden index and odds ratio of MRI in the diagnosis of ACL rupture combined with Ramp lesions were calculated.According to the arthroscopic diagnosis results,the included patients were divided into the Ramp lesions group and non-Ramp lesions group.The gender,age,ACL rupture type,ACL rupture degree,posterior cruciate ligament(PCL)injury,posterolateral tibial bone contusion,posteromedial tibial bone contusion,medial collateral ligament(MCL)injury,lateral collateral ligament(LCL)injury,medial meniscus(MM)injury and lateral meniscus(LM)injury were compared between the 2 groups,and the onset characteristics of ACL rupture combined with Ramp lesions was then analyzed.Results:Four hundred and sixty-three patients were included in the final analysis,78 cases in Ramp lesions group and 385 cases in non-Ramp lesions group.The ACL rupture combined with Ramp lesions was confirmed by MRI examination in 40 patients(including false-positive result in 2 cases)and by arthroscopy in 78 cases.The consistency of diagnosis results was moderate between the 2 physicians(Kappa=0.598).The sensitivity,specificity,positive predictive value,negative predictive value,Youden index and odds ratio of MRI in diagnosing ACL rupture combined with Ramp lesions were 48.7%,99.5%,95.0%,90.5%,48.2% and 181.925 respectively.The incidence rates of chronic ACL rupture and posteromedial tibial bone contusion were higher in Ramp lesions group compared to non-Ramp lesions group(χ2=10.179,P=0.001; χ2=7.507,P=0.006).There was no statistical difference in gender,age,ACL rupture degree,PCL injury,posterolateral tibial bone contusion,MCL injury,LCL injury,MM injury and LM injury between the 2 groups(χ2=0.852,P=0.356; χ2=2.680,P=0.444; χ2=3.296,P=0.069; χ2=0.005,P=0.943; χ2=2.143,P=0.143; χ2=2.276,P=0.131; χ2=3.008,P=0.083; χ2=3.087,P=0.079; χ2=3.001,P=0.083).Conclusion:MRI has a certain application value in the diagnosis of ACL rupture combined with Ramp lesions which is mainly characterized by chronic ACL rupture and posteromedial tibial bone contusion.

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更新日期/Last Update: 1900-01-01