高分辨率超声对三角纤维软骨复合体损伤的诊断价值

Diagnostic value of high-resolution ultrasonography for triangular fibrocartilage complex injuries

目的探讨高分辨率超声对三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)损伤的诊断价值。方法研究分析我院因腕关节疾患行腕关节镜手术的48例患者,其中TFCC损伤34例,腕关节其他疾患TFCC正常14例,进行TFCC高分辨率超声检查,以关节镜探查结果为金标准,通过对比TFCC超声成像和关节镜下表现,进行统计研究,得出高分辨率超声诊断TFCC损伤及损伤部位的敏感度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比。结果高分辨率超声诊断TFCC损伤的敏感度为0.9375、特异度为0.875、阳性预测值为0.9375、阴性预测值为0.875、阳性似然比为7.5、阴性似然比为0.071,诊断TFCC中央型退变穿孔的敏感度为0.9629、特异度为0.9048、阳性预测值为0.9285、阴性预测值为0.95、阳性似然比为10.11、阴性似然比为0.041,诊断TFCC尺侧止点损伤的敏感度为0.95、特异度为1、阳性预测值为1、阴性预测值为0.9655、阳性似然比为+∞、阴性似然比为0.05。结论高分辨率超声对诊断TFCC损伤,特别是临床常见的TFCC中央型退变穿孔和尺侧止点损伤具有肯定的价值,值得进一步深入研究其方法及诊断标准。

Objective To investigate the value of high-resolution ultrasound in the diagnosis of triangular fibrocartilage complex(TFCC)injuries.Methods Forty-eight patients who underwent wrist arthroscopic surgery for wrist diseases in our hospital were studied and analyzed,including 34 cases of TFCC injury and 14 cases of other wrist diseases with normal TFCC.The TFCC high-resolution ultrasound was performed.Taking the results of arthroscopic exploration as the gold standard,the statistical research was carried out by comparing TFCC ultrasound imaging and arthroscopic manifestations.The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of high-resolution ultrasound in the diagnosis of TFCC injury and injury site were obtained.Results The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of high-resolution ultrasound in the diagnosis of TFCC injury were 0.9375,0.875,0.9375,0.875,7.5,and 0.071 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio for the diagnosis of central degenerative perforation of TFCC were 0.9629,0.9048,0.9285,0.95,10.11 and 0.041 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of high-resolution ultrasound in the diagnosis of TFCC ulnar insertion injuries were 0.95,1,1,0.9655,+∞and 0.05 respectively.Conclusion High resolution ultrasound has certain value in the diagnosis of TFCC injury,especially the common clinical TFCC central degenerative perforation and ulnar insertion injuries,which is worthy of further study on its method and diagnostic criteria.