生理盐水扩张关节腔后B超对半月板损伤的诊断

B-ultrasound Examination for Diagnosis of Meniscus Lesions of the Knee Joint

目的 研究生理盐水扩张关节后Ｂ超对半月板损伤的诊断价值及临床可行性。方法实验部分，用２０ 条猪后肢。在水下用金属钩经皮造成半月板损伤，先以７．５ ＭＨｚ 超声探头行常规扫查，然后向关节腔内注入２０ ｍｌ 生理盐水再行扫查。记录两种检查方法的诊断结果及解剖关节腔后的发现。临床部分，共查１６ 例。关节腔注入生理盐水５０～６０ ｍｌ，注水前后分别以７．５ ＭＨｚ 超声探头扫查，记录结果并与术中发现比较。结果 实验组注入生理盐水扩张前诊断敏感度、特异度、准确度分别为６１．１％ 、９０％ 、７１．４％ ；扩张后分别为９４．４％ 、８０％ 、８９．３％ ；注入生理盐水前后结果比较差异有显著性意义（Ｐ＜ ０．０５）。临床组注入生理盐水后诊断敏感度、特异度及准确度均高于注入生理盐水前，未发现与注入生理盐水扩张有关的并发症。结论 注入生理盐水扩张的方法改善了半月板损伤的超声可视性，诊断较明确，临床可行。

Objective To introduce a joint dilation technique during sonographic examination for meniscus tears, for assessing its clinical value and clinical reliability. Methods Twenty swine knee joints were used. After artificial meniscal lesion was made with a metalic hock under water (for prevention of gas intervention),regular sonographic scan with a 7.5 MHz sector scanner was performed first, then 20 ml physiological saline was injected into the knee joint and sonographic examination was performed again. The results of the above two methods and that of postmortem findings were compared statistically. Clinically, 16 cases were examined before and after joint distention with 50-60 ml of physiological saline. Ultrasound results, reactions after injection and intraoperative findings were documented. Results Experimentally, the rate of sensitivity, specificity and diagnostic coincidence was 61.1%, 90%, 71.4%before joint distention, and 94.4%, 80%, 89.3%after joint distention, respectively. Significant statistical deviation was observed between the two methods. Clinically, joint dilation method revealed higher rate of sensitivity, specificity and diagnostic coincidence. No complication related to joint dilation technique was observed. Conclusion Joint dilation sonographic examination offers a better opportunity to visualize meniscus lesion and can be applied clinically.