肌骨超声评价肝肾亏虚型膝骨关节炎软骨损伤的诊断价值  

Diagnostic Value of Musculoskeletal Ultrasound on Evaluation of Cartilage Injury in Knee Osteoarthritis of Liver-Kidney Deficiency Type

作　　者：万蓉[1] 巫海旺 曾兰芬[1] 贾节[1] WAN Rong;WU Haiwang;ZENG Lanfen;JIA Jie

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《新中医》2020年第13期85-88,共4页New Chinese Medicine

基　　金：广东省科技计划项目(2013B021800230)。

摘　　要：目的:分析肌骨超声评价肝肾亏虚型膝骨关节炎软骨损伤的诊断价值。方法:回顾性分析172例肝肾亏虚型膝骨关节炎患者行关节置换术前的膝关节超声及磁共振成像(MRI)检查结果,并与术中所见的股骨滑车、內侧髁及外侧髁软骨损伤相对照,分析超声诊断软骨损伤的声像图特征,比较膝关节肌骨超声与MRI的诊断符合率、诊断效能。结果:肝肾亏虚型膝骨关节炎患者的膝关节超声表现除有滑膜炎声像图改变外,股骨滑车内、外侧软骨病变明显,主要表现为软骨分层不清,局部软骨明显变薄、缺失,软骨下骨面不平整。MRI组诊断符合率90.70%,肌骨超声组诊断符合率84.30%,2组比较,差异无统计学意义(P>0.05)。ROC曲线表明肌骨超声评价膝关节软骨损伤的诊断效能高,与MRI诊断效能一致。结论:膝关节肌骨超声检查诊断膝骨关节炎及评价关节软骨损伤的价值高,而且费用低廉,无禁忌证,可作为膝骨关节炎辅助诊断及疗效评价的重要手段,尤其适宜在缺少MRI设备的基层医院使用。Objective:To analyze the diagnostic value of musculoskeletal ultrasound on the evaluation of cartilage injury in patients with knee osteoarthritis of liver-kidney deficiency type.Methods:The results of ultrasonic and magnetic resonance imaging(MRI)of knee joint before joint replacement in 172 patients with knee osteoarthritis of liver-kidney deficiency type were retrospectively analyzed,and the analytical results were compared with the cartilage damage of femoral trochlear,medial condyle and lateral condyle appeared in the operation.Then the sonographic characteristics of ultrasonic diagnosis of cartilage injury was analyze and the diagnostic coincidence rate and diagnostic efficacy of ultrasonic diagnosis of knee musculobone and MRI were compared.Results:The ultrasonic manifestations of knee joint in patients with knee osteoarthritis of liver-kidney deficiency type not only showed the lesion of synovitis,but also the obvious lesions of medial and lateral cartilage of the femoral trochlear,mainly including unclear layers of cartilage,obviously thinned and missing local cartilage,and rough subchondral surface.The diagnostic coincidence rate was 90.70%in the MRI group and 84.30%in the musculoskeletal ultrasound group,there being no significant difference(P>0.05).ROC curve showed that the diagnosis efficiency of musculoskeletal ultrasound in the diagnosis of knee cartilage injury was high,which was consistent with that of MRI.Conclusion:Musculoskeletal ultrasound is of high value in diagnosing knee osteoarthritis and evaluating articular cartilage injury,with low cost and no contraband,which can be used as an important method for grading treatment and effect evaluation of knee osteoarthritis,especially in primary hospitals lacking MRI equipment.

关 键 词：膝骨关节炎 肌骨超声 肝肾亏虚型 诊断符合率 诊断效能 

分 类 号：R684.3[医药卫生—骨科学]