■通常引用的盘状外侧半月板(DLM)成像定义是基于成人磁共振成像(MRI)测量。这种病理常见于儿科人群;然而,接受的成人测量是否可靠地适用于儿童和青少年尚不清楚.
■这项研究的目的是确定(1)将成人接受的DLMMRI定义应用于儿科患者的实用性,(2)性别差异是否影响标准的适用性,和(3)MRI磁体强度和/或撕裂存在是否影响MRI测量以诊断儿科患者的DLM。据推测,成人和儿科患者的DLMMRI标准相似。
■案例系列;证据级别,4.
■共评估了100例DLM儿科患者的连续MRI,包括91次扫描。两名研究作者独立审查了MRI,在矢状和冠状图像上评估半月板高度和宽度,矢状图像上的“领结标志”,胫骨矢状和冠状宽度,撕裂存在。为了进行分析,MRI磁体强度分为高(>1.5T)和低(<1.5T)组。
■MRI评估患者的平均年龄为12.3±3.4岁;51%的患者为男性,56%的扫描是左膝。纳入的DLM患者显示平均3.68个领结体征,矢状面前后半月板宽度/胫骨宽度比为73%,冠状半月板宽度/胫骨宽度比为30%,和一个日冕,侧半月板在半月板体中部的横向宽度为20.6±7.7毫米。本研究中包含的图像的MRI特斯拉强度范围为0.3至3。确定高分辨率MRI扫描与低分辨率MRI扫描不影响MRI测量的观察者间或观察者内可靠性(P>.05)。然而,几项测量显示,随着特斯拉强度的增加,组内相关系数得到改善。
■这项研究证实,患有DLM的儿科患者,由董事会认证的儿科运动医学骨科医生诊断,MRI测量结果符合成人DLM诊断标准。无论性别或MRI特斯拉强度如何,这一发现都是正确的。患有DLM的儿科患者有>3个领结体征,>70%矢状胫骨平台覆盖率,>14毫米的冠状宽度,MRI显示冠状胫骨平台覆盖率>20%。
UNASSIGNED: Commonly cited discoid lateral meniscus (DLM) imaging definitions are based on adult magnetic resonance imaging (MRI) measurements. This pathology commonly presents in pediatric populations; however, whether accepted adult measurements reliably apply to children and adolescents is unknown.
UNASSIGNED: This purposes of the study were to determine (1) the utility of applying adult-accepted MRI definitions of DLM to pediatric patients, (2) whether sex differences affect the applicability of the criteria, and (3) whether MRI magnet strength and/or tear presence affect MRI measurements for diagnosing DLM in pediatric patients. It was hypothesized that MRI criteria for DLM would be similar in adults and pediatric patients.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: A total of 100 consecutive MRIs from pediatric patients with DLM were evaluated, with 91 scans included. Two study authors independently reviewed the MRIs, evaluating meniscal height and width on sagittal and coronal images, \"bow tie signs\" on sagittal images, tibial sagittal and coronal width, and tear presence. For analysis, MRI magnet strength was dichotomized into high (>1.5 T) and low (<1.5 T) groups.
UNASSIGNED: The mean age of the patients at MRI evaluation was 12.3 ± 3.4 years; 51% of the patients were male, and 56% of the scans were of left knees. Included patients with DLM showed a mean of 3.68 bow tie signs, a sagittal total anterior to posterior meniscal width/tibial width ratio of 73%, a coronal meniscal width/tibial width ratio of 30%, and a coronal, transverse width of the lateral meniscus at the midportion of the meniscal body of 20.6 ± 7.7 mm. The MRI tesla strength of the images included in this study ranged from 0.3 to 3. It was determined that high- versus low-resolution MRI scans did not affect the inter- or intraobserver reliability of the MRI measurments (P > .05). However, several measurements showed improved intraclass correlation coefficients with increased tesla strength.
UNASSIGNED: This study confirms that pediatric patients with DLM, diagnosed by board-certified pediatric sports medicine orthopaedic surgeons, have measurements on MRI consistent with adult DLM diagnostic criteria. This finding held true regardless of sex or MRI tesla strength. Pediatric patients with DLM had >3 bow tie signs, >70% sagittal tibial plateau coverage, >14 mm coronal width, and >20% coronal tibial plateau coverage on MRI.