高频超声与磁共振对急性外伤性髌骨外侧脱位后内侧髌股韧带损伤的对比研究  

Comparative study of high-frequency ultrasonography and MRI in diagnosis of medial pateilofemoral ligament injury after acute lateral traumatic patellar dislocation

作　　者：张广英[1] 郑雷 史浩[2] 曲素慧[1] 李荔[1] 丁红宇[1] 

机构地区：[1]山东大学附属千佛山医院超声诊疗科,济南250014 [2]山东大学附属千佛山医院超声影像科,济南250014 [3]武警山东省总队医院影像科

出　　处：《中华超声影像学杂志》2012年第12期1060-1063,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金项目（31000048,31170091）; 食品科学与技术国家重点实验室目标导向课题（SKLF-MB-201002）;自由探索课题（SKLF-TS-200916）; 赣鄱英才555工程人才计划（2012年）

摘　　要：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后内侧髌股韧带（MPFL）损伤的诊断价值。方法回顾性分析35例经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，分析MPFL损伤发生率、损伤部位，计算高频超声、MRI诊断MPFL损伤的敏感性、特异性和准确性，比较两种检查方法的有效性。结果急性外伤性髌骨外侧脱位后，MPFL损伤发生率为100％，其中完全性MPFL撕裂21例，部分性MPFL撕裂14例，股骨侧撕裂19例，髌骨侧撕裂15例，中段体部撕裂1例；与手术结果比较，高频超声诊断MPFL部分撕裂的敏感性、特异性、准确性分别为78．6％、95．2％、88．6％，MRI诊断MPFL部分撕裂的敏感性、特异性、准确性分别为85．7％、90．5％、88．6％；高频超声诊断MPFL完全撕裂的敏感性、特异性、准确性分别为95．2％、78．6％、88．6％，MRI诊断MPFL完全撕裂的敏感性、特异性、准确性分别为90．5％、85．7％、88．6％。高频超声对MPFL部分撕裂、完全撕裂的诊断与MRI比较差异无统计学意义（Y。=0．243、0．267，P=0．622、0．599）。结论急性外伤性髌骨外侧脱位后，MPFL股骨侧最易损伤，其次为髌骨侧，高频超声与MRI检查同样能对MPFL损伤明确诊断和准确分级，是一种简单可靠、快捷可重复的诊断方法，可作为急性外伤性髌骨外侧脱位后MPFL损伤的常规检查方法。Objective To compare high-frequency ultrasonography and MRI in diagnosis of medial patellofemoral ligament （MPFL） injury after acute lateral traumatic patellar dislocation（LTPD）. Methods According to surgical data of 35 patients with acute LTPD, the incidence and sites of MPFL injury were analyzed. Further, based on high-frequency ultrasonography and MRI data, the sensitivity, specificity and accuracy of high frequency ultrasonography and MRI in different MPFL injuries were analyzed and compared. Results Among 35 patients, there were 21 cases with complete MPFL tear and 14 cases with partial MPFL tear. Tear of MPFL at the femoral attachment in 19 cases, at the patellar attachment in 15 cases, and at the mid-substance in 1 case. The sensitivity, specificity, accuracy of high-frequency ultrasonography diagnosis were 78.6%, 95.2%, 88.6% respectively on partial MPFL tear and 95.2%, 78.6% ,88.6% respectively on complete MPFL tear. The sensitivity, specificity, accuracy of MRI diagnosis were 85.7% ,90.5%,88.6% respectively on partial MPFL tear and 90.5% ,85.7% ,88.6% respectively on complete MPFL tear. There were no significant difference between high-frequency ultrasonography and MRI in diagnosis of partial and complete MPFL injury （X2 = 0. 243,0. 267; P = 0. 622,0. 599）. Conclusions MPFL formoral attachment is most vulnerable to damage,followed by patellar attachment. High-frequency ultrasonography,as well as MRI, can be used clearly to diagnose MPFL injury and accurately classify the damage,and it is also an easy, reliable, rapid method, which can be applied routinely to diagnose MPFL injury after actue LTPD.

关 键 词：超声检查 磁共振成像 髌骨脱位 内侧髌股韧带 

分 类 号：R684[医药卫生—骨科学]