İstemi YÜCEL, Hüsamettin ÇAKICI, Melih GÜVEN, Kamil GÜREL, Kutay Engin ÖZTURAN

Menisküs Ve Bağ Yaralanmalarının Manyetik Rezonans Görüntüleme Ve Artroskopik Cerrahi Bulgularının Karşılaştırılması

Amaç: Manyetik rezonans görüntüleme dizde menisküs ve bağ yaralanmalarının tanısındasıklıkla kullanılmaktadır. Bu çalışmadaki amacımız dizdeki bu tip patolojilerin artroskopisonuçları ile manyetik rezonans görüntüleme verilerinin retrospektif olarak karşılaştırılmasıdır.Yöntem: Travma sonrası klinik olarak menisküs ve/veya bağ yaralanması düşünülen vemanyetik rezonans görüntüleme tetkiki yapılmış 62 hasta çalışmaya dahil edildi. Hastalarınortalama yaşı 36.8 (dağılım 18–69 yaş) idi. Hastaların 37’si (%59.7) erkek iken 25’si (%40.3)kadın idi. 35 (%56.5) sol, 27 (%43.5) sağ dizde yaralanma mevcuttu. Klinik değerlendirmedeve manyetik rezonans görüntülemede patoloji düşünülüp diz artroskopisi yapılmış hastalarınmanyetik rezonans görüntüleme ve artroskopi sonuçları değerlendirildi.Bulgular: Artroskopi sonuçlarına göre 35 (%56.4) hastada izole medial menisküs yırtığı, 11(%17.7) hastada izole lateral menisküs yırtığı, 5 (%8) hastada izole ön çapraz bağ yaralanması,2 (%3.2) hastada medial menisküs yırtığı ve ön çapraz bağ yaralanması, 2 (%3.2) hastada lateralmenisküs yırtığı ve ön çapraz bağ yaralanması, 5 (%8) hastada medial menisküs ve lateralmenisküs yırtığı, 2 (%3.2) hastada medial menisküs, ön çapraz bağ ve arka çapraz bağ yırtığıtespit edildi. Yapılan değerlendirmede manyetik rezonans görüntülemede medial menisküs içinsensitivite %95,5, spesifite %76,4, pozitif prediktif değeri (PPD) %91.4, negatif prediktif değeri(NPD) %86.6, doğruluk oranı %90,3; lateral menisküs için sensitivite %72.2, spesifite %93.1,PPD %81.2, NPD %89,1, doğruluk oranı %87; ön çapraz bağ için sensitivite %90.9, spesifite%88.2, PPD %62.5, NPD %97.8, doğruluk oranı %88.7; arka çapraz bağ için sensitivite %100,spesifite %98.3, PPD %66.6, NPD %100, doğruluk oranı %98.3 olarak tespit edilmiştir.Sonuç: Manyetik rezonans görüntüleme dizde menisküs ve bağ yaralanmalarının tanısındagüvenle kullanılabilecek bir tetkikdir

Anahtar Kelimeler:

Manyetik rezonans görüntüleme, artroskopi, menisküs

Comparison Of The Magnetic Resonance Imaging And Knee Arthroscopy Findings Of The Menisci And Ligamentous Injuries

Purpose: Magnetic resonance imaging is frequently used in the diagnosis of the meniscal andligamentous injuries. The aim of this study is to compare the results of the knee arthroscopyand magnetic resonance imaging findings retrospectively.Methods: Of the sixty-two patients 37 (59.7%) were male and 25 (40.3%) were female. Theaverage age was 36.8 years (range 18-69 years). Patients who had been clinically diagnosedwith meniscal and/or ligamentous injuries and subsequently undergone further magneticresonance imaging examination were included to the study. The left knee was involved in 35(56.5%) and the right knee in 27 (43.5%) cases. Patients had gone to knee arthroscopyaccording to clinical examination and magnetic resonance imaging findings, and the resultswere evaluated.Results: 35 (56.4%) of the 62 patients had isolated medial meniscal tear, 11 (17.7%) isolatedlateral meniscal tear and 5 (8%) had isolated complete anterior cruciate ligament injury. 2 (3.2%)had medial meniscal tear and anterior cruciate ligament complete injury, 2 (3.2%) had lateralmeniscal tear and complete anterior cruciate ligament injury and 5 (8%) had medial and lateralmeniscal tear. 2 (3.2%) had medial meniscal tear, anterior and posterior cruciate ligamentcomplete injuries. Magnetic resonance imaging evaluation of the medial meniscus, lateralmeniscus, anterior cruciate ligament and posterior cruciate ligament revealed sensitivity 95.5%,72.2%, 90.9%, 100%, specificity 76.4%, 93.1%, 88.2%, 98.3%, positive predictive value91.4%, 81.2%, 62.5%, 66.6%, negative predictive value 86.6%, 89.1%, 97.8%, 100%, andaccuracy 90.3%, 87.0%, 88.7%, 98.3% respectively.Conclusion: Magnetic resonance imaging is a safe and appropriate evaluation in the diagnosisof the meniscal and ligament injuries of the knee

Keywords:

Magnetic resonance imaging, arthroscopy, meniscus,

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