高频超声与MRI在诊断膝关节软骨退变中的比较

A Comparison Between High-frequency Ultrasound and MRI in the Diagnosis of Knee Articular Cartilage Degeneration

目的 :比较高频超声与MRI在诊断膝关节软骨退变中的应用价值。方法 :收集2015年1月～2016年12月因外伤所致半月板或韧带损伤于我院行关节镜检查的200例患者的临床资料,入院后均行高频超声与MRI检查,且临床资料完整,均以关节镜检查为金标准,评定高频超声与MRI诊断膝关节软骨退变的临床价值。结果 :①200例患者共检查1000个关节面,关节镜结果显示:420个关节面软骨表面光滑,弹性好,为正常软骨,其余580个关节面共检出654处病变,其中Ⅰ期114处,Ⅱ期172处,Ⅲ期192处,Ⅳ期176处;高频超声显示494个关节面均见正常覆盖骨表层高-低-高样回声,其余506个关节面共检出580处软骨病变,包括滑车中央沟80处、滑车中央沟内侧斜面140处、滑车中央沟外侧斜面112处、股骨内髁136处及外髁112处。分期:Ⅰ期78处,Ⅱ期202处,Ⅲ期170处,Ⅳ期130处;MRI显示:472个关节面均见膝关节软骨正常,部分软骨见弥漫性均匀变薄,表面光滑,其余528个关节面共检出602处软骨病变,包括滑车中央沟86处,滑车中央沟内侧斜面137处及外侧斜面110处,股骨内髁146处及外髁123处。分期:Ⅰ期87处,Ⅱ期171处,Ⅲ期170处,Ⅳ期174处。②高频超声、MRI对膝关节软骨退变分期准确率分别为64.80%、76.90%。结论 :高频超声、MRI对膝关节软骨退变诊断价值较高,对关节软骨退变程度诊断较为敏感,且超声操作简单、无创、扫描时间短、价格低廉,可作为膝关节软骨退变的首选筛查手段。

Objective To compare the applied value between high-frequency ultrasound and MRI in the diagnosis of knee articular cartilage degeneration.Methods Collecting the clinical data of 200 patients with meniscal or ligament injury caused by trauma and accepted arthroscopy in our hospital from January 2015 to December 2016,all of whom were examined by high-frequency ultrasound and MRI after being admitted to our hospital,and their clinical data are completed.With arthroscopy as the gold standard,the clinical value of high-frequency ultrasound and MRI in the diagnosis of Knee Articular Cartilage Degeneration was evaluated.Results(1)A total of 1000 articular surfaces of the 200 patients were examined,and the arthroscopy showed420 of them are normal cartilage which are smooth and elastic.A total of 654 lesions were found in the other 580 articular surfaces,including 114 lesions at stageⅠ,172 lesions at stageⅡ,192 lesions at stageⅢand 176 lesions at stageⅣ.In addition,High-frequency ultrasound detected high-low-high echo of normal covering bone surfaces among 494 articular surfaces.580 cartilage lesions were detected among the other 506 articular surfaces,including 80 lesions at trochlea central sulcus,140 lesions on the inside slope of trochlea central sulcus,112 lesions on the outside slope of trochlea central sulcus,136 lesions at inner condyle of the femur and 112 lesions at the external condyle of the femur.In terms of stages,there were 78 lesions at stageⅠ,202 lesions at stageⅡ,170 lesions at stageⅢand 130 lesions at stageⅣ.While MRI showed that there were normal cartilages on 472 articular surfaces,and some cartilages with smooth surface were witnessed evenly diffused thinning.There were 602 cartilage lesions detected on the other 528 articular surfaces,including 86 lesions at trochlea central sulcus,137 lesions on the inside slope of trochlea central sulcus,110 lesions on the outside slope of trochlea central sulcus,146 lesions at inner condyle of the femur and 123 at the external condyle of the femur.In terms of stages.In terms of stages,there were 87 lesions at stageⅠ,171 lesions at stageⅡ,170 lesions at stageⅢand 174 lesions at stageⅣ.(2)The accuracy rates of high-frequency ultrasound and MRI in the diagnosis of Knee Articular Cartilage Degeneration were 64.80%and 76.90%respectively.Conclusion The applied value of high-frequency ultrasound and MRI are relatively high in the diagnosis of Knee Articular Cartilage Degeneration,and they are sensitive in diagnosing different degrees of Knee Articular Cartilage Degeneration.Meanwhile,Highfrequency ultrasound is easy to operate and noninvasive,with shorter scanning time and lower price.Therefore,it can be used as the preferred method for detecting Knee Articular Cartilage Degeneration.