论文部分内容阅读
目的 通过与腕关节镜结果对照,评估磁共振成像MRI在诊断腕三角纤维软骨复合体(TFCC)损伤中的敏感性及特异性,并分析原因.方法 对48例临床怀疑腕TFCC损伤的患者行常规MRI检查(其中19例行3.0T检查,29例行1.5T检查),并且同时行关节镜检查,术后由影像科高年资主治医师回顾性分析患者术前MRI(在对关节镜结果未知的情况下),通过与腕关节镜结果对照,分析MRI诊断TFCC损伤的敏感性及特异性.结果 关节镜下证实15例TFCC未有明显撕裂或穿孔,33例TFCC存在撕裂或穿孔;而影像科高年资主治医师通过读片,判定TFCC存在撕裂或穿孔30例,未有明显撕裂或穿孔18例,其中造成5例假阴性和2例假阳性(3.0T检查出现1例假阴性和1例假阳性,1.5T检查出现4例假阴性和1例假阳性).MRI诊断TFCC损伤的敏感性达85％,特异性达87％,准确性达85％,而在具体的损伤定位方面33例中判断准确24例,准确性达73％.结论 MRI(尤其是3.0T MRI)对于诊断TFCC损伤有较高的敏感性、特异性和准确性,但仍需注意因对TFCC解剖认识不清或读片能力不足等原因出现的错误结果.“,”Objective To evaluate the sensitivity and specificity of MRI in the diagnosis of triangular fibrocartilage complex (TFCC) injuries by comparing with wrist arthroscopy findings,and to analyze the reasons for discrepancy.Methods Forty-eight patients with clinically suspected TFCC injuries underwent conventional MRI in our hospital from 2007 to 2013(19 cases underwent 3.0 T scanning while 29 cases were examined with a 1.5 T scanner).Wrist arthroscopy was also conducted in these patients to examine the lesion.A senior attending physician from the department of radiology who was blinded of the wrist arthroscopic findings reviewed all the MRI scans and gave his interpretation of the readings.The sensitivity and specificity of MRI in diagnosing TFCC injuries were determined by comparing MRI readings with arthroscopic findings.Results Wrist arthroscopy confirmed 15 cases without TFCC tear or perforation,and 33 cases with TFCC tear or perforation.The MRI interpretation by the senior attending radiologist determined TFCC tear or perforation in 30 cases,and no obvious TFCC tear or perforation in 18 cases.There were 5 false negative cases and 2 false positive cases(readings from 3.0 T scans yielded 1 false negative and 1 false positive,while readings from 1.5 T scans yielded 4 false negative and 1 false positive).The diagnostic sensitivity,specificity and accuracy of MRIin TFCC lesions were 85％,87％ and 85％,respectively.Localization of the lesion site was correct in 24 of the 33 cases achieving an accuracy rate of 73 ％.Conclusion MRI(especially 3.0 T MRI) has high sensitivity,high specificity and high accuracy in diagnosing TFCC injuries.However erroneous interpretation can occur due to lack of anatomical knowledge of TFCC or inexperience in image reading.