高频超声与磁共振对急性外伤性髌骨外侧脱位的对比研究

Comparative study of high-frequency ultrasonography and MRI in diagnosis of acute lateral traumatic patellar dislocation

目的比较分析高频超声与磁共振(MRI)对急性外伤性髌骨外侧脱位的诊断价值。方法对33例临床证实急性外伤性髌骨外侧脱位的高频超声和MRI资料,以手术结果为金标准,计算高频超声、MRI诊断各种伴随伤的敏感性、特异性和准确性,比较两种检查方法的有效性。结果与手术结果比较,高频超声、MRI诊断MPFL部分撕裂的敏感性、特异性、准确性分别为85.7%、85.7%,94.7%、89.5%,90.9%、87.9%;诊断MPFL完全撕裂的敏感性、特异性、准确性分别为94.7%、89.5%,85.7%、85.7%,90.9%、87.9%。高频超声、MRI诊断关节软骨Ⅱ级损伤的敏感性、特异性、准确性分别为36.4%、81.8%,85%、100%,67.7%、93.5%。高频超声、MRI诊断关节软骨Ⅲ级损伤的敏感性、特异性、准确性分别为81.8%、90.9%,85%、90%,83.9%、90.3%;高频超声、MRI诊断关节软骨Ⅳ级损伤的敏感性、特异性、准确性分别为100%、100%,90.9%、95.5%,93.5%、96.8%。高频超声对MPFL撕裂、关节软骨损伤的诊断与MRI比较差异无统计学意义(P>0.05)。结论高频超声检查与MRI检查同样能对急性外伤性髌骨外侧脱位的各种伴随损伤明确诊断和准确分级,是一种简单可靠、快捷并可重复的诊断方法,可作为急性外伤性髌骨外侧脱位的常规检查方法。

Objective To compare and analyze clinical value of high-frequency ultrasonography and MRI in diagnosis of actue lateral traumatic patellar dislocation （LTPD）. Methods The high frequency ultrasonography and MRI results of 33 patients with actue LTPD confirmed by surgery were compared based on the operative results. Results The sensitivity, specificity, accuracy of high frequency ultrasonography and MRI diagnosis on partial medial patellofemoral ligament （MP- FL） tear were 85.7%, 85.7%, 94.7%, 89.5%, 90.9%, 87.9% respectively. The sensitivity, specificity, accuracy of high-frequency ultrasonography and MRI diagnosis on complete MPFL tear were 94. 7%, 89. 5%, 85. 7%, 85. 7%, 90.9%, 87.9% respectively. The sensitivity, specificity, accuracy of high-frequency ultrasonography and MRI diagnosis on grade II articular cartilage injury were 36.4%, 81.8%, 85%, 100%, 67.7%, 93.5% respectively. The sensitivity, specificity, accuracy of high-frequency ultrasonography and MRI diagnosis on grade III articular cartilage injury were 81.8%/00, 90.9%, 85%, 90%, 83.9%, 90.3% respectively. The sensitivity, specificity, accuracy of high-frequency ultra-sonography and MRI diagnosis on grade IV articular cartilage injury were 100%, 100%%, 90. 9%, 95. 5%, 93. 5%, 96.8% respectively. There were no differences between high frequency ultrasonography and MRI for diagnosis of MPFL injury, articular cartilage injury （ P %0.05）. Conclusion High-frequency ultrasonography can show injuries after actue LTPD clearly and accurately classified compared with MRI. High-frequency ultrasonography is an easy, reliable, rapid method and may be applied routinely in diagnosing injuries after acute LTPD.