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目的探讨与前交叉韧带(ACL)损伤相关性最大的MRI征象。方法回顾性分析124例患者的MRI图像,分别计算5个征象诊断ACL损伤的敏感性、特异性及准确性;通过Logistic后退回归法,分析与ACL损伤相关性最大的MRI征象。结果 ACL中断诊断ACL损伤的敏感性、特异性及准确性分别为13.8%、97.3%、38.7%;ACL信号或(和)走行异常诊断ACL损伤的敏感性、特异性及准确性分别为85.1%、91.9%、87.1%;PCL指数诊断ACL损伤的敏感性、特异性及准确性分别为51.7%、27.0%、44.4%;胫骨前移诊断ACL损伤的敏感性、特异性及准确性分别为62.1%、94.6%、71.7%;半月板后角裸露征诊断ACL损伤的敏感性、特异性及准确性分别为46.0%、92.0%、59.7%。与ACL损伤的相关性由大至小:ACL信号或(和)走行异常;ACL中断;胫骨前移;半月板后角裸露征;PCL指数。结论 ACL走行及信号异常是ACL损伤相关性最大的因素,胫骨前移是ACL损伤相关性最大的间接征象。
Objective To investigate the MRI findings that have the highest correlation with anterior cruciate ligament (ACL) injury. Methods The MRI images of 124 patients were retrospectively analyzed. The sensitivity, specificity and accuracy of 5 signs were evaluated respectively. The MRI findings with the largest correlation with ACL injury were analyzed by Logistic regression regression. Results The sensitivity, specificity and accuracy of ACL diagnosis for ACL injury were 13.8%, 97.3% and 38.7% respectively. The sensitivity, specificity and accuracy of ACL signal or / and abnormal walking ACL diagnosis were 85.1% , 91.9%, 87.1%. The sensitivity, specificity and accuracy of the PCL index in the diagnosis of ACL injury were 51.7%, 27.0% and 44.4% respectively. The sensitivity, specificity and accuracy of tibial advancement in the diagnosis of ACL injury were 62.1 %, 94.6% and 71.7% respectively. The sensitivity, specificity and accuracy of nuchal ACL were 46.0%, 92.0% and 59.7% respectively. Correlation with ACL injury descending: ACL signal or (and) walking abnormalities; ACL interruption; tibial advancement; meniscus posterior horn exposed sign; PCL index. Conclusion ACL walking and signal abnormalities are the most important factors of ACL injury. Tibial advancement is the most indirect indirect symptom of ACL injury.