MRI征象检测半月板根部撕裂的诊断准确性：与关节镜所见的前瞻性比较
简介
前瞻性纳入50例临床疑似半月板根部撕裂患者，比较术前MRI与关节镜所见。MRI诊断敏感度90.9%、特异度82.4%、总体准确率88.0%，与关节镜结果高度一致（P<0.001）。识别典型MRI征象有助于早期诊断和手术规划，但关节镜仍是可疑病例的确诊手段。
英文摘要
INTRODUCTION: Meniscal root tears (MRTs) are increasingly recognized as significant injuries that compromise knee biomechanics and accelerate cartilage degeneration if left untreated. Magnetic resonance imaging (MRI) is widely used for the pre-operative assessment of MRTs; however, knee arthroscopy remains the gold standard for definitive diagnosis. Evaluating the diagnostic accuracy of MRI is essential for improving early detection and treatment planning. OBJECTIVES: The objective of the study is to evaluate the diagnostic accuracy of MRI signs in predicting MRTs using knee arthroscopy as the reference standard. MATERIALS AND METHODS: A prospective observational diagnostic accuracy study was conducted among 50 patients with clinically suspected MRTs at a tertiary care hospital. All participants underwent pre-operative MRI followed by knee arthroscopy. MRI findings, including ghost sign, truncation sign, radial tear, meniscal extrusion, and associated abnormalities, were compared with arthroscopic findings. Arthroscopy served as the gold standard for diagnosis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), overall diagnostic accuracy, and Chi-square test were calculated using IBM Statistical Package for the Social Sciences Statistics Version 29.0. RESULTS: Among the 50 patients, the majority were males (64.0%) and belonged to the 31-40 years age group (30.0%). Arthroscopy confirmed MRTs in 33 (66.0%) patients. MRI correctly identified 30 true-positive, 14 true-negative, 3 false-positive, and 3 false-negative cases. MRI demonstrated a sensitivity of 90.9%, specificity of 82.4%, PPV of 90.9%, NPV of 82.4%, and an overall diagnostic accuracy of 88.0%. A statistically significant association was observed between MRI and arthroscopic findings (χ2 = 28.64, P < 0.001). CONCLUSION: MRI demonstrated high diagnostic accuracy in predicting MRTs and showed excellent agreement with arthroscopic findings. Recognition of characteristic MRI signs can facilitate early diagnosis, appropriate surgical planning, and timely management. Nevertheless, arthroscopy remains the definitive diagnostic modality in clinically suspicious or inconclusive cases.