目的 探讨磁共振成像(M RI)在膝关节软骨损伤分级诊断中的应用价值.方法 选择2016年1月至12月我院收治的经关节镜或手术证实的膝关节软骨损伤患者150例,所有患者术前均行M RI检查.分析诊断结果 ,并以关节镜或手术结果为金标准,评价M RI对不同分级膝关节软骨损伤的诊断效能.结果以关节镜或手术诊断结果为标准,常规T2WI序列诊断的灵敏度、特异度、准确度分别为98.9%、89.6%、95.7%,对Ⅰ~Ⅳ级软骨损伤的阳性预测值分别为80.1%、84.4%、94.6%和98.0%(Kappa=0.902,P<0.05);STIR序列诊断的灵敏度、特异度、准确度分别为98.2%、92.7%、96.3%,对Ⅰ~Ⅳ级软骨损伤的阳性预测值分别为87.8%、88.2%、96.2%和98.0%(Kappa=0.918,P<0.05).结论 MRI诊断膝关节软骨损伤的灵敏度和特异度均较高,且与关节镜或手术分级诊断膝关节软骨损伤具有良好的一致性.%Objective To investigate the value of magnetic resonance imaging (MRI) in grading diagnosis of knee articular cartilage injury .Methods From January 2016 to December 2016 ,150 patients with knee articular cartilage injury confirmed by arthroscopy or surgery admitted in our hospital were selected ,and all the patients were examined by MRI before operation .We evaluated the diagnostic efficacy of MRI for different grades of knee articular cartilage injury ,according to the diagnosis result of arthroscopy or surgery .Results Based on the results of arthroscopic or surgical diagnosis ,the sensitivity ,specificity and accuracy of T 2WI sequence in diagnosis of knee articular cartilage injury were 98 .9% ,89 .6% and 95 .7% ,respectively .And the positive predictive values of that in diagnosis of the grade Ⅰ ,Ⅱ ,Ⅲ and Ⅳ cartilage injury were 80 .1% ,84 .4% ,94 .6% and 98 .0% ,re-spectively (Kappa=0 .902 ,P <0 .05) .In addition ,the sensitivity ,specificity and accuracy of STIR sequence in diagnosis of knee articular cartilage injury were 98 .2% ,92 .7% and 96 .3% ,respectively .And the positive pre-dictive values of that in diagnosis of the grade Ⅰ ,Ⅱ ,Ⅲ and Ⅳ cartilage injury were 87 .8% ,88 .2% ,96 .2%and 98 .0% ,respectively (Kappa = 0 .918 ,P <0 .05) .Conclusion MRI has high sensitivity and specificity in the diagnosis of knee articular cartilage injury ,and a good agreement was found in the grading diagnosis of knee articular cartilage injury with arthroscopy or surgery .
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