超声诊断膝关节软骨退行性变的影响因素分析  

Analysis Ultrasound of Influence Factors in Diagnosing Knee Articular Cartilage Degeneration

作　　者：任杰[1] 黄冬梅[1] 郑荣琴[1] 袁晓峰[1] 蔡道章[2] 

机构地区：[1]中山大学附属三院超声科,广州市510630 [2]中山大学附属三院骨科,广州市510630

出　　处：《中国超声医学杂志》2008年第2期165-167,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广东省医学科研基金项目资助(NoB2006051)

摘　　要：目的分析超声诊断膝关节软骨退行性变(退变)的一些影响因素。方法选择行膝关节镜手术患者36例37个膝关节及关节置换术患者4例4个膝关节,共41个膝关节。术前1周行超声检查,超声诊断结果与关节镜或大体标本肉眼所见结果对比。对超声误诊、漏诊病例进行回顾性分析。结果本组234处病灶,超声诊断真阳性病灶87处,假阳性病灶8处,假阴性病灶47处,真阴性病灶92处,诊断敏感性、特异性、准确性分别为64.9%、92.0%、76.5%。超声对软骨退变的分期与关节镜分期相关(r=0.703,P<0.01),但有59处病灶(59/234,25.2%)两者分期不符。影响超声诊断准确性的因素主要包括(1)病变部位,(2)病变程度,(3)临床治疗过程,(4)一些与超声成像原理有关的一般性影响因素。结论超声检测膝关节软骨退变操作较复杂,影响因素也多。正确认识这些因素,有助于更好地理解声像图,避免漏诊误诊。Objective To analyze some influence factors in diagnosing knee articular cartilage degeneration using ultrasound （US） .Methods Forty patients （41 knees） who underwent arthroscopic surgery or total knee arthroplasty were included in the study group. Each knee was evaluated on US one week before operation. Comparison of the US results with the arthroscopic findings was performed. All false US results were reviwed. Results The results of US identification of cartilage degeneration were： true positive sites in location, 87, false positive sites in 8, false negative sites in 47, and true negative sites in 92. Its sensitivity, specificity and accuracy were 64.9% ,92.0% ,and 76. 5% ,respectively. Cartilage degeneration grades determined with US were correspondant with arthroscopic grades. The correlation coefficient was 0. 703. But, there were 59 cartilage sites whose US grades were not coherent with arthroscopic grades. The Influence factors included ①focus position, ②cartilage degeneration grades, ③ clinical therapeutic proeess and ④ some common factors related to acoustic theory. Conclusions Recognizing the influence factors in diagnosing knee articular cartilage degeneration will help comprehend US images and avoid misdiagnosis.

关 键 词：膝关节 软骨退行性变 超声 

分 类 号：R684.3[医药卫生—骨科学] R687.4[医药卫生—外科学]