膝骨关节炎MSCT、MRI的影像学特征及联合应用的诊断价值

Imaging features of MSCT and MRI in degenerative knee osteoarthritis and diagnostic value of combined application

摘要:

目的 探讨膝骨关节炎多层螺旋计算机断层扫描（MSCT）、磁共振成像（MRI）的影像学特征，分析两者联合诊断的效能。方法 回顾性分析2017年1月—2018年3月北京市和平里医院接收的疑似膝骨关节炎受检者78例的临床资料，分别实施MSCT、MRI检查。所有受试者行关节镜检查明确膝骨关节炎的发生情况，将其作为“金标准”。总结MSCT、MRI的影像学表现，绘制受试者工作特征（ROC）曲线，分析不同方法的诊断效能。结果 全组受试者中共有102膝确诊为膝骨关节炎，MSCT、MRI诊断该病均有典型的特征；MSCT、MRI、两者联合诊断膝骨关节炎的敏感性分别为86.27%（95% CI：0.786，0.897）、95.10%（95% CI：0.824，0.959）、98.04%（95% CI：0.855，0.987）；特异性分别为77.78%（95% CI：0.712，0.798）、90.74%（95% CI：0.866，0.913）、98.15%（95% CI：0.890，0.985）；准确性分别为83.33%、93.89%、98.08%；AUC分别为0.712（95% CI：0.502，0.851）、0.806（95% CI：0.671，0.855）、0.913（95% CI：0.782，0.974）（P <0.05）。联合诊断的敏感性、特异性、准确性和AUC均高于单独诊断。结论 MSCT、MRI诊断膝骨关节炎有典型的影像学特征，且两者联合诊断的效能更佳。

Abstract:

Objective To explore the imaging features of multislice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in the diagnosis of degenerative knee osteoarthritis, and to analyze their combined diagnostic efficacy.Methods The clinical data of 78 patients with suspected degenerative knee osteoarthritis admitted to our hospital from January 2017 to March 2018 were analyzed retrospectively. MSCT and MRI were performed respectively. All subjects underwent arthroscopy to determine the incidence of degenerative knee osteoarthritis as the "gold standard". The imaging features of MSCT and MRI were summarized, receiver operating characteristic curve (ROC) was drawn, and the diagnostic efficacy of different methods was analyzed.Results In this group, 102 knees were diagnosed as degenerative osteoarthritis, and MSCT and MRI had typical characteristics. The sensitivities of MSCT, MRI, and combined methods in the diagnosis of degenerative knee osteoarthritis were 86.27% (95% CI: 0.786, 0.897), 95.10% (95% CI: 0.824, 0.959), and 98.04% (95% CI: 0.855, 0.987), respectively; the specificity data were 77.78% (95% CI: 0.712, 0.798), 90.74% (95% CI: 0.866, 0.913), and 98.15% (95% CI: 0.890, 0.985), respectively; the accuracy data were 88.33%, 93.89%, and 98.08%, respectively; AUC were 0.712 (95% CI: 0.502, 0.851), 0.806 (95% CI: 0.671, 0.855), and 0.913 (95% CI: 0.782, 0.974) (all P < 0.05). The sensitivity, specificity, accuracy and AUC of the combined method were higher than those of the single diagnosis.Conclusion MSCT and MRI have typical imaging features in the diagnosis of degenerative knee arthritis, and the combined diagnosis is more effective.