[1]张雷,郭林,马超,等.动态及应力条件下超声对膝关节半月板损伤的诊断价值[J].第三军医大学学报,2018,40(11):1017-1021.
 ZHANG Lei,GUO Lin,MA Chao,et al.Diagnostic value of ultrasound on meniscus injury under dynamic activity and stress[J].J Third Mil Med Univ,2018,40(11):1017-1021.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第11期
页码:
1017-1021
栏目:
临床医学
出版日期:
2018-06-15

文章信息/Info

Title:
Diagnostic value of ultrasound on meniscus injury under dynamic activity and stress
作者:
张雷郭林马超彭阳罗江明杨柳
陆军军医大学(第三军医大学)第一附属医院关节外科中心
Author(s):
ZHANG Lei GUO Lin MA Chao PENG Yang LUO Jiangming YANG Liu

Center for Joint Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
动态应力作用超声半月板损伤
Keywords:
stress dynamic effect ultrasound meniscus injury
分类号:
R445.1; R684
文献标志码:
A
摘要:

目的    以术中关节镜探查结果为金标准,探讨动态应力超声在诊断膝关节半月板损伤中的价值。方法    连续收集本院2016年12月至2017年6月经MRI诊断前交叉韧带(anterior cruciate ligament,ACL)断裂入院需行关节镜下前交叉韧带重建术的患者40例(80例半月板),其中男性31例,女性9例,年龄15~40(28.0±5.4)岁,BMI 19.8~25.2(23.2±2.9)kg/m2。术前所有入组患者行双膝内、外侧半月板静态和动态及应力超声检查,通过关节镜下探查结果比对,判断静态、动态及应力条件下超声对半月板损伤及不稳的诊断价值。结果    关节镜术中证实80例半月板中存在42例半月板损伤,静态超声对半月板损伤诊断的敏感性、特异性、阳性预测值、阴性预测值分别为78.6%、78.9%、80.5%、76.9%;动态及应力条件下超声分别为42.9%、97.4%、94.7%、60.6;静态结合动态及应力条件下超声后4项指标分别为92.8%、89.5%、83.3%、90.6%;MRI 4项指标分别为95.2%、97.4%、97.6%、94.5%。结合动态活动及应力作用,可有效提高超声对半月板损伤诊断的特异性和阳性预测值;静态结合动态及应力超声,可显著提升诊断敏感性、特异性及阴性预测值。 结论    动态及应力条件下超声可作为诊断半月板损伤的有效补充。

Abstract:

Objective    To evaluate the value of dynamic stress ultrasound in the diagnosis of meniscus injury of knee joint. Methods    A total of 40 consecutive patients (80 menisci) with anterior cruciate ligament (ACL) tear diagnosed by MRI and undergoing arthroscopic surgery in our hospital from December 2016 to June 2017 were enrolled in this study. They were 31 males and 9 females, at an age of 28.0±5.4(15~40) years, and at a BMI of  23.2±2.9(19.8 to 25.2) kg/m2. Static and stress dynamic ultrasound examinations were performed preoperatively on the medial and lateral meniscus of the double knees in all patients, and the results were compared with the arthroscopic exploration results. The value of static, dynamic and stress ultrasound were evaluated for meniscus tear and diagnosis of instability. Results    The results of arthroscopy indicated that there were 42 cases of meniscus tear in the 40 patients. And static ultrasound had the sensitivity, specificity, and positive and negative predictive value for the diagnosis of meniscus were 78.6%, 78.9%, 80.5%, and 76.9%, respectively. The values were 42.9%, 97.4%, 94.7% and 60.6% respectively for the stress dynamic ultrasound. When the results of static and stress dynamic ultrasound were combined together, the values were 92.8%, 89.5%, 83.3% and 90.6%. For MRI, the values were 95.2%, 97.4%, 97.6% , 97.6% and 94.5%. Combination of dynamic and stress ultrasound effectively improved the specificity and positive predictive value in the diagnosis of meniscus injury, and in addition with the static ultrasound, the sensitivity, specificity and negative predictive value of the diagnosis were further improved. Conclusion    Stress dynamic ultrasound examination is an effective supplement in the diagnosis of meniscus injury.

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更新日期/Last Update: 2018-06-14