MRI Evaluation Of Meniscus Injuries Of Knee Joint And Comparison With Arthroscopy

Objective:Evaluate the accuracy of MRI in the diagnosis of knee meniscus injury.To further understand the relationship between meniscus and other structural injury and explore the causes of missed diagnosis and misdiagnosis.To further understand the relationship between knee meniscus tear and other structure injury of knee joint.Methods:The MRI and arthroscopy data of 136 patients with suspected meniscus injury in our hospital were retrospectively analyzed,5 5 cases have the history of acute knee trauma and then take MRI examination within 6 weeks after trauma.MRI diagnosis of meniscus and other structure injury was confirmed by three radiologists.Arthroscopic surgery was performed by the physician of orthopaedics department and detailed records of the procedure were recorded.Compare the MRI and arthroscopic findings of meniscus,To calculate the sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of MRI in the diagnosis of meniscus injury.Then to investigate the causes of missed diagnosis and misdiagnosis.Analyzed the data of 55 cases with history of acute knee trauma and taking MRI examination within 6 weeks after trauma.Correlation analysis was used to determine the relationship between meniscus tear and other structure injury.Result:?Sensitivity,specificity,positive predictive values,negative predictive value,accuracy rate of MRI diagnosis of medial and lateral meniscus injury was 93.5%and 94.1%,88.6%and 88.2%,94.5%and 88.9%,86.7%and 93.8%respectively.Both Kappa value were 0.82.?In 13 cases of misdiagnosis,4 cases were high signal transferring part of the lateral meniscus posterior horn and the adjacent femoral ligament.3 cases were attachment of the anterior horn of lateral meniscus and the anterior cruciate ligament to the tibial plateau.1 cases with high signal of lateral meniscus horn was caused by meniscus contusion.In the case of medial meniscus,5 cases showed a high signal conjunction between the anterior horn of the medial meniscus and the transverse ligament of the knee.In 10 cases of missed diagnosis,Arthroscopy shows slight tear or minor damage of the meniscus.?Meniscal tear is associated with other structure injury(OR=4.24),sprain was the most common cause of traumatic meniscus tear.Medial meniscus tears are usually accompanied by contusion of medial tibial plateau and medial femoral condyle,injury of anterior cruciate ligament and lateral collateral ligament,and abrasion of articular cartilage.The lateral meniscus tears are usually accompanied by the contusion of the lateral tibial plateau and the lateral femoral condyle,rupture of the anterior cruciate ligament and the medial collateral ligament,and injury of the articular cartilage.Conclusion:MRI has high efficiency in diagnosis of meniscal injury.However,the complexity of the knee joint structure will affect the accuracy of diagnosis.For the patients with suspected meniscus injury,we should not only pay attention to the signal changes of meniscus itself,but also should distinguish between position of meniscus and adjacent structure and to avoid the misdiagnosis and missed diagnosis.Traumatic meniscus tears are often associated with other structure injury of the knee,sprain was the most common cause of traumatic meniscus tear,the location and shape of the meniscus tear can lead to the discovery of other structure injuries of the knee joint.