【摘要】：目的評價磁共振(MR)成像檢查評估膝關(guān)節(jié)剝脫性骨軟骨炎(OCD)分級及穩(wěn)定性的能力。方法由2名放射診斷醫(yī)師獨(dú)立回顧性分析47例經(jīng)關(guān)節(jié)鏡證實(shí)的膝關(guān)節(jié)OCD患者的術(shù)前MR圖像,按照OCD國際軟骨修復(fù)協(xié)會分類標(biāo)準(zhǔn)將OCD病變分成4級,與關(guān)節(jié)鏡結(jié)果進(jìn)行對照,計算MR評價OCD穩(wěn)定性的特異度、敏感度和準(zhǔn)確度,計算Kappa值,評價2名醫(yī)師之間MR診斷OCD分級的一致性。計算提示膝關(guān)節(jié)OCD不穩(wěn)定的MR征象診斷不穩(wěn)定OCD的特異度、敏感度及準(zhǔn)確度。結(jié)果 47例患者中,48個OCD病灶,Ⅰ、Ⅱ、Ⅲ、Ⅳ級OCD分別為4、8、16、20例,2名醫(yī)師MR術(shù)前診斷OCD穩(wěn)定性的特異度、敏感度、準(zhǔn)確度分別為75.0%(83.3%)、88.9%(86.1%)、85.4%(85.4%),2名醫(yī)師診斷OCD分級的一致性較好(Kappa=0.82)。提示膝關(guān)節(jié)OCD不穩(wěn)定的MR征象:病灶與母體骨交界面線狀高信號、病灶鄰近骨質(zhì)多發(fā)囊變影或出現(xiàn)大囊變(直徑5 mm)、累及全層的軟骨骨折線、累及全層的軟骨缺損診斷膝關(guān)節(jié)OCD穩(wěn)定性的特異度、敏感度、準(zhǔn)確度分別為83.3%、80.6%、81.3%;75.0%、72.2%、72.9%;66.7%、69.4%、68.8%;100%、86.1%、89.6%。結(jié)論軟骨缺損是診斷不穩(wěn)定OCD最特異的MR征象,而軟骨骨折線的準(zhǔn)確率最低。膝關(guān)節(jié)MR檢查是評價OCD穩(wěn)定性及分級比較可靠的方法。
[Abstract]:Objective to evaluate the ability of (MR) to evaluate the (OCD) grading and stability of osteochondrositis of the knee. Methods the preoperative MR images of 47 cases of knee joint OCD confirmed by arthroscopy were analyzed retrospectively by two radiologists. According to the OCD International Association of cartilage Restoration Classification, the OCD lesions were classified into 4 grades and compared with the results of arthroscopy. The specificity, sensitivity and accuracy of MR in evaluating the stability of OCD were calculated. The Kappa value was calculated and the consistency of MR diagnostic OCD grading between two physicians was evaluated. The results showed that the specificity, sensitivity and accuracy of the MR signs of OCD instability in the diagnosis of unstable OCD. Results among the 47 patients, 48 OCD lesions (鈪，

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