膝关节内侧副韧带损伤的高频超声及MRI的检查对比

Comparison of high frequency ultrasound and MRI examination in medial collateral ligament injury

目的探讨膝关节内侧副韧带(MCL)损伤的高频超声与MRI检查的对比。方法选择临床拟诊为膝关节MCL损伤的患者52例,其中男性37例,女性15例;年龄20~65岁,平均年龄40岁。全部患者行高频超声及MRI检查,并与关节镜结果进行比较,分析两者诊断吻合度的差异。结果 52例临床拟诊膝关节MCL损伤患者中经关节镜证实,43例为MCL损伤,6例为滑囊炎及钙化,3例正常。以关节镜手术结果为标准,高频超声诊断膝关节MCL损伤41例,滑囊炎2例,钙化2例,阴性7例;诊断符合率84.6%,误诊率15.4%,漏诊率0%。MRI诊断膝关节MCL损伤42例,滑囊炎2例,韧带钙化2例,阴性6例;MRI诊断符合率86.5%,误诊率13.5%,漏诊率0%。MCL损伤患者中,超声诊断Ⅲ级损伤10例,Ⅱ级损伤18例,Ⅰ级损伤13例;MRI诊断Ⅲ级损伤10例,Ⅱ级损伤20例,Ⅰ级损伤12例。高频超声同MRI一致,对膝关节MCL损伤的诊断吻合度较强,差异有统计学意义(K=0.985,P=0.000)。结论高频超声有助于膝关节MCL损伤的诊断,可作为膝关节MCL损伤的常规检查方法。

Objective To compare the high-frequency ultrasound and MRI examination in medial collateral ligament(MCL)injury. Methods A total of 52 patients diagnosed as MCL injury were enrolled, which included 37 males and 15 females,aged 20-65 years old with mean age of 40 years old. All of them performed high-frequency ultrasound and MRI, then results were compared with surgical results, and the difference in diagnostic accuracy of 2 groups was analyzed. Results The 52 patients with clinically diagnosed MCL were confirmed by arthroscopy. Among them, 43 cases showed MCL injury, 6 of bursitis and calcification and 3 of normal. According to surgical results, in high-frequency ultrasound diagnosis, 41 cases were MCL injury, 2 of bursitis, 2 of calcification and 7 of negative;the diagnostic compliance rate was 84.6 %, misdiagnosis rate of 15.4 %and without missed diagnosis. In MRI diagnosis, 42 cases were MCL injury, 2 of bursitis, 2 of ligament calcification and 6 of negative. The coincidence rate of MRI diagnosis was 86.5 %, misdiagnoses rate of 13.5 % and without missed diagnosis. In MCL injury patients, 10 cases of grade Ⅲ injury were diagnosed by ultrasound, 18 of grade Ⅱ injury, and 13 of grade Ⅰinjury. MRI diagnosed 10 cases of grade Ⅲ injury, 20 of grade Ⅱ injury, and 12 of grade Ⅰ injury. The high-frequency ultrasound was consistent with MRI in diagnosis of MCL injury, and the difference was statistically significant( K = 0.985,P = 0.000). Conclusion It is demonstrated that high-frequency ultrasound helps to diagnose MCL injury of knee joint and could be used as routine examination method for knee joint MCL injury.