Translated Abstract
ABSTRACT
OBJECTIVE
1) Evaluation the accuracy of low field Magnetic Resonance Image (MRI) in the assessing of cartilage defects of the knee through Meta-analysis method.
2) Collection the patients after knee cartilage injury, to observe the value of low-field MRI in grading diagnosis of articular cartilage injury of knee; to compare the consistency of test results and the value of property in the evaluating method of arthroscopy and preoperative assessments.
METHODS
1) Retrieve the Chinese and English paper recorded by Cochrane Library, Pub med, Medline and Elsevier and China national knowledge index (CNKI), which was published between 1990 and 2013. According to the corresponding inclusion and exclusion criteria, we screened and evaluated the literature. Meta-analysis was performed in State software version 12.0 and Meta-disc version 1.4. The pooled results, heterogeneity, as also as sensitivity, specificity and their 95% confidence interval (CI). Receiver operating characteristic curve (SROC) has been plotted and the area under the curve (AUC) has been calculated.
2) Retrospective analysis the patients of orthopedic knee cartilage damage due to the use of the knee examination or treatment in our hospital during January 2009 and September 2012. Taking the results of arthroscopy as standards ,the value of low-field MRI in grading diagnosis of articular cartilage injury was evaluated; MRI image was used in the assessment of knee cartilage defect area, and compare this data with the arthroscopy measurement results.
RESULTS
1) A total of 11 studies were included in our study. In these paper, four was in Chinese and eight was in English. All the included literature were met at least 10 item of 14 item in Quality Assessment of Studies of Diagnostic Accuracy (QUADAS), a We define the gold standard was ＂arthroscopic＂, the results showed that the sensitivity, specificity and SROC curve under the area of low-field MRI in the diagnosis of knee cartilage defects was 86%(95%CI：84%～89%）, 84%(95%CI：81%~87%）and 89.8%, respectively. In addition, the Q * index was 0.829.
2) Low field MRI in the articular cartilage of the knee injury in low field MRI in the diagnosis of cartilage damage total sensitivity was 89.2%, specificity was 96.7%, the cartilage I ~ IV grade damage sensitivity respectively is 37.8%, 83.7%, 94.2%, 100%.
The average cartilage defect area per knee was (1.9±0.29) cm2 when measured by Low-field MRI. However, the average cartilage defect area per knee was (2.8±0.44) cm2 by arthroscopic measurement. There were significant statistical difference between Low-field MRI and arthroscopy (P ＜0.001). The measurement results of Low-field MRI evaluation was lower than that of arthroscopic, the average difference was (1.7 ± 1.1) cm2. The area of Low-field MRI measurement was 70.1% of the measurement results of arthroscopic.
CONCLUSION
1)Low field MRI in the diagnosis of knee joint cartilage injury has high diagnostic value, the diagnosis result is stable, high reliability, can be a reliable basis for clinical diagnosis and treatment of further.
2)Low field MRI in the diagnosis of knee joint cartilage injury and arthroscopic diagnosis with good consistency, on knee joint cartilage Ⅱ - Ⅳlevel damage with arthroscopy indifference, level of Ⅰ damage detection are different; For damage area of knee joint Ⅲ - Ⅳ level measurement results with measurement results intraoperative arthroscopy can help guide the percentage of preoperative treatment decisions to make.
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