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超声检查对评估犬颅交叉韧带断裂后膝关节损伤的诊断价值:13例病例

Diagnostic value of ultrasonography to assess stifle lesions in dogs after cranial cruciate ligament rupture: 13 cases.

作者信息

Arnault F, Cauvin E, Viguier E, Kraft E, Sonet J, Carozzo C

机构信息

National Veterinary School of Lyon, Université Claude Bernard - CHEVAC, Department of Small Animal Surgery, 1 Avenue Bourgelat, Marcy l'Etoile, France.

出版信息

Vet Comp Orthop Traumatol. 2009;22(6):479-85. doi: 10.3415/VCOT-08-10-0103. Epub 2009 Oct 29.

Abstract

The objective of this study was to evaluate the accuracy of ultrasonographic diagnosis of lesions in the canine stifle associated with cranial cruciate ligament rupture. Thirteen dogs that had a diagnosis of cranial cruciate ligament rupture were included in this prospective clinical study. Two ultrasonographers who were unaware of specific historical and clinical data performed the sonography with a high frequency (8-16 MHz) linear transducer. Surgical treatment of the affected stifle was performed within two days of ultrasonography by a surgeon who was unaware of the ultrasonographic findings. The lesions observed during ultrasonography and arthrotomy were compared at the completion of the study. Visualisation of the superficial tendons (quadriceps and long digital extensor) and ligaments (patellar ligament, collateral ligaments) of the stifle using ultrasonography was excellent. However, the detection of deep stifle ligaments (cranial cruciate ligament and caudal cruciate ligament) was extremely difficult to perform using ultrasonography. For cranial cruciate ligament rupture, the sensitivity for ultrasonographic diagnosis was 15.4%. For meniscal lesions, the sensitivity, specificity, positive and negative predictive values for ultrasonographic diagnosis were 82%, 93%, 90% and 88% respectively. High frequency ultrasonography is a non-invasive method for accurately and efficiently detecting superficial ligaments, tendons and meniscal lesions associated with cranial cruciate ligament rupture in the stifle of non-sedated dogs.

摘要

本研究的目的是评估超声诊断犬膝关节与颅侧十字韧带断裂相关病变的准确性。本前瞻性临床研究纳入了13只被诊断为颅侧十字韧带断裂的犬。两名不了解具体病史和临床数据的超声检查人员使用高频(8 - 16 MHz)线性探头进行超声检查。在超声检查后两天内,由一名不了解超声检查结果的外科医生对患侧膝关节进行手术治疗。在研究结束时,比较超声检查和关节切开术中观察到的病变。使用超声检查对膝关节的浅表肌腱(股四头肌和趾长伸肌)和韧带(髌韧带、侧副韧带)的可视化效果极佳。然而,使用超声检查很难检测到膝关节深部韧带(颅侧十字韧带和尾侧十字韧带)。对于颅侧十字韧带断裂,超声诊断的敏感性为15.4%。对于半月板损伤,超声诊断的敏感性、特异性、阳性预测值和阴性预测值分别为82%、93%、90%和88%。高频超声是一种非侵入性方法,可准确、有效地检测未镇静犬膝关节中与颅侧十字韧带断裂相关的浅表韧带、肌腱和半月板损伤。

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