动态超声联合高场强MR诊断髌内侧膝关节滑膜皱襞及评估分型、软骨损伤分级的价值  

The Value of Dynamic Ultrasound Combined with High-Field Magnetic Resonance Imaging in the Diagnosis of Synovial Plica of the Medial Patellar Knee Joint and Evaluation of Classification and Cartilage Injury Grading

作　　者：王志利 徐丹凤 李楠 焦嫣 尚瑞松 Wang Zhili;Xu Danfeng;Li Nan;Jiao Yan;Shang Ruisong(Imaging Center,Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院影像中心,河北省衡水市053000

出　　处：《中国超声医学杂志》2024年第10期1146-1151,共6页Chinese Journal of Ultrasound in Medicine

基　　金：2023年度河北省医学科学研究课题计划(No.20232183)。

摘　　要：目的探究动态超声联合高场强磁共振(MR)成像系统诊断髌内侧膝关节滑膜皱襞及评估分型、软骨损伤分级的价值,以期为临床早期评估诊断、制订治疗方案提供参考。方法选取100例疑似髌内侧膝关节滑膜皱襞患者,均行动态超声、高场强MR检查。以关节镜检查结果为“金标准”,统计比较动态超声、高场强MR单独、联合诊断髌内侧膝关节滑膜皱襞的价值,并分析动态超声、高场强MR单独、联合评估髌内侧膝关节软骨损伤分级、滑膜皱襞分型与关节镜检查结果的一致性。结果100例疑似髌内侧膝关节滑膜皱襞患者中,经动态超声共检出69例,经高场强MR共检出73例,联合诊断检出80例;与动态超声、高场强MR单独诊断比较,联合诊断灵敏度为98.73%,准确度为97.00%,比单独诊断高(P<0.05);动态超声、高场强MR及联合诊断髌内侧膝关节滑膜皱襞分型与关节镜检查结果一致性Kappa值分别为0.839、0.865、0.912,软骨损伤分级与关节镜检查结果一致性Kappa值分别为0.793、0.839、0.902。结论动态超声、高场强MR可联合用于髌内侧膝关节滑膜皱襞诊断中,临床可通过其进行早期筛查诊断、术前评估分型及软骨受损程度,以针对性展开后续治疗,改善预后。Objective To explore the value of dynamic ultrasound combined with high-field magnetic resonance(MR)imaging systems in diagnosing synovial plica in the medial patellar knee joint and evaluating its classification and cartilage injury grading,with a view to providing reference for early clinical evaluation and diagnosis and formulating treatment plans.Methods A total of 100 patients with high suspicion of medial patellar knee joint synovial plica were selected for initial diagnosis.All patients underwent dynamic ultrasound and high-field MR examination.Taking the results of arthroscopy as the“gold standard”,the value of dynamic ultrasound and high-field MR alone and in combination in the diagnosis of medial patellar knee joint synovial plica was compared,and the consistency of dynamic ultrasound and high-field MR alone and in combination in evaluating the classification of medial patellar knee joint synovial plica,cartilage injury grading,and arthroscopy results was analyzed.Results Among 100 patients with suspected medial patellar synovial crease,69 cases were detected by dynamic ultrasound,73 cases were detected by high-field MR,and 80 cases were detected by combined diagnosis;compared with dynamic ultrasound and high-field MR alone,the combined diagnosis had a higher sensitivity of 98.73%and accuracy of 97.00%(P<0.05);dynamic ultrasound,high-field MR and combined diagnosis were more sensitive for medial patellar synovial crease.Kappa values were 0.839,0.865,and 0.912 for synovial crease typing and arthroscopic examination of the knee,respectively,and 0.793,0.839,and 0.902 for cartilage injury grading and arthroscopic examination,respectively.Conclusions Dynamic ultrasound and high-field MR can be used in combination for the diagnosis of medial patellar synovial plica.Clinically,they can be used for early screening and diagnosis,preoperative evaluation and classification,and assessment of cartilage damage,so as to provide targeted follow-up treatment and improve prognosis.

关 键 词：超声 高场强磁共振 膝关节滑膜皱襞 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686.7[医药卫生—诊断学]