影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (4): 942-946.DOI: 10.7517/issn.1674-0475.220104

• 综述与论文 • 上一篇    下一篇

肌肉骨骼超声对膝关节滑膜炎的诊断分析

彭晓松1, 曲小雨1, 刘培林2   

  1. 1. 南阳医学高等专科学校针灸骨伤系, 河南 南阳 473000;
    2. 濮阳市人民医院创伤骨科, 河南 濮阳 457000
  • 收稿日期:2022-01-11 发布日期:2022-07-09
  • 通讯作者: 彭晓松

Diagnosis Analysis of Knee Joint Synovitis by Musculoskeletal Ultrasound

PENG Xiaosong1, QU Xiaoyu1, LIU Peilin2   

  1. 1. Department of Acupuncture and Orthopedics, NanYang Medical College, Nanyang 473000, Henan, P. R. China;
    2. Department of Traumatology, Puyang People's Hospital, Puyang 457000, Henan, P. R. China
  • Received:2022-01-11 Published:2022-07-09

摘要: 本文探讨了肌肉骨骼超声(MSUS)在膝关节滑膜炎中的诊断价值及与疾病严重程度的关系。选取疑似膝关节滑膜炎患者86例112个膝关节,比较X线、MSUS诊断膝关节滑膜炎差异,以及分析MSUS半定量分析与Lysholm评分、Ayral评分关系。经关节镜检查,有33例患者43个膝关节确诊为膝关节滑膜炎,53例患者69个膝关节无滑膜病变;MSUS诊断膝关节滑膜炎的灵敏性、准确率和阴性预测值明显高于X线(P<0.05);MSUS和X线诊断膝关节滑膜炎的特异性和阳性预测值比较,差异无统计学意义(P>0.05);Lysholm评分≥70分膝关节血流信号、滑膜增生、关节积液和骨侵蚀Ⅱ级及以上比例明显高于Lysholm评分<70分膝关节(P<0.05);Ayral评分≥60分膝关节血流信号、滑膜增生、关节积液和骨侵蚀Ⅱ级及以上比例明显高于Ayral评分<60分膝关节(P<0.05);Lysholm评分与MSUS滑膜增生、骨侵蚀评分呈正相关(rs=0.714和0.741,P<0.05);Ayral评分与MSUS滑膜增生呈正相关(rs=0.613,P<0.05)。MSUS诊断膝关节滑膜炎有较好的价值,同时MSUS半定量分级与膝关节功能、滑膜程度有关。

关键词: 肌肉骨骼超声, 膝关节滑膜炎, 诊断价值, 严重程度

Abstract: This paper discussed the diagnostic value of musculoskeletal ultrasound (MSUS) in the knee joint synovitis and its relationship with disease severity. A total of 86 patients (112 knees) with suspected knee synovitis were selected, the differences of X-ray and MSUS in the diagnosis of knee synovitis were compared, and the relationship between semi quantitative analysis of MSUS and Lysholm score, Ayral score was analyzed. Through arthroscopy, 43 knees of 33 patients were diagnosed as synovitis, and 69 knees of 53 patients had no synovial lesions. The sensitivity, accuracy and negative predictive value of MSUS in the diagnosis of knee synovitis were significantly higher than those of X-ray (P<0.05). There was no significant difference in specificity and positive predictive value between MSUS and X-ray in the diagnosis of knee synovitis (P>0.05). The blood flow signals, synovial hyperplasia, joint effusion and bone erosion Ⅱ level and above proportion of knee with Lysholm score ≥ 70 points were significantly higher than those of Lysholm score<70 knee (P<0.05). The blood flow signals, synovial hyperplasia, joint effusion and bone erosion Ⅱ level and above proportion of knee with Ayral score ≥ 60 points were significantly higher than the knee with Ayral score < 60 (P<0.05). The Lysholm score was positively correlated with MSUS score of synovial hyperplasia and bone erosion (rs=0.714 and 0.741, P<0.05). Ayral score was positively correlated with MSUS synovial hyperplasia (rs=0.613, P<0.05). MSUS has a good value in the diagnosis of knee synovitis, and the semi quantitative classification of MSUS is related to the function of knee joint and the degree of synovium.

Key words: musculoskeletal ultrasound, knee synovitis, diagnostic value, severity