一种可靠的基于超声的盘状外侧半月板诊断方法。
A Reliable, Ultrasound-Based Method for the Diagnosis of Discoid Lateral Meniscus.
机构信息
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China; Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China; Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
出版信息
Arthroscopy. 2021 Mar;37(3):882-890. doi: 10.1016/j.arthro.2020.09.034. Epub 2020 Sep 28.
PURPOSE
To explore the feasibility and validity of ultrasound in the diagnosis of discoid lateral meniscus (DLM) by comparing quantitatively the morphologic difference between DLM and normal lateral meniscus.
METHODS
This study was designed to develop and validate the ultrasound diagnostic criterion for DLM. In the development stage (July 2018 to June 2019), data from 180 subjects were used to derive the ultrasound diagnostic criterion, including 90 patients diagnosed as DLM by magnetic resonance imaging (DLM group) and 90 matched controls diagnosed as normal lateral meniscus diagnosed by magnetic resonance imaging (control group). Twelve distinct parameters of meniscus thickness, width, 0.5∗thickness/width, and angle were obtained through anterior, lateral, and posterior views with the probe oriented perpendicular to the lateral tibiofemoral joint line. In the validation stage (July 2019 to December 2019), data from 324 additional participants were used to validate the criterion derived from the development stage. Differences of the continuous variables and categorical variables between the 2 groups were analyzed by an independent t test and χ test, respectively. The diagnostic value of parameters was analyzed by the receiver operating characteristic curve.
RESULTS
In the development stage, significant differences were found in the above 12 parameters between the 2 groups (P < .05 for all). Cut-off values of anterior meniscus angle, meniscus body angle, and posterior meniscus angle were 28.45°, 27.85°, and 29.15°, respectively. The area under the curve, sensitivity, and specificity of anterior meniscus angle (0.953, 95.6%, 91.1%), meniscus body angle (0.980, 95.6%, 95.6%), and posterior meniscus angle (0.942, 80.0%, 97.8%) were greater than other parameters. In the validation stage, the sensitivity, specificity, and accuracy of anterior meniscus angle, meniscus body angle, and posterior meniscus angle in diagnosing DLM were as high as 91.3%, 88.6%, and 89.2%; 94.2%, 93.3%, and 93.5%; and 76.8%, 95.7%, and 91.7%.
CONCLUSIONS
DLM can be reliably diagnosed by ultrasound measurements of anterior meniscus angle, meniscal body angle, and posterior meniscus angle.
LEVEL OF EVIDENCE
Level III, case-control study.
目的
通过比较盘状外侧半月板（DLM）与正常外侧半月板的形态差异，探讨超声诊断 DLM 的可行性和有效性。
方法
本研究旨在建立并验证超声诊断 DLM 的标准。在开发阶段（2018 年 7 月至 2019 年 6 月），使用 180 例受试者的数据得出超声诊断标准，包括 90 例经磁共振成像（MRI）诊断为 DLM 的患者（DLM 组）和 90 例经 MRI 诊断为正常外侧半月板的匹配对照（对照组）。通过探头垂直于外侧胫股关节线从前侧、外侧和后侧获得半月板厚度、宽度、0.5*厚度/宽度和角度等 12 个特征参数。在验证阶段（2019 年 7 月至 2019 年 12 月），使用另外 324 名参与者的数据验证了从开发阶段得出的标准。采用独立 t 检验和卡方检验分别对两组间连续变量和分类变量的差异进行分析。通过受试者工作特征曲线分析各参数的诊断价值。
结果
在开发阶段，两组间上述 12 个参数存在显著差异（均 P <.05）。前半月板角、半月板体角和后半月板角的截断值分别为 28.45°、27.85°和 29.15°。前半月板角（0.953、95.6%、91.1%）、半月板体角（0.980、95.6%、95.6%）和后半月板角（0.942、80.0%、97.8%）的曲线下面积、敏感度和特异度均大于其他参数。在验证阶段，前半月板角、半月板体角和后半月板角诊断 DLM 的敏感度、特异度和准确度分别高达 91.3%、88.6%和 89.2%；94.2%、93.3%和 93.5%；76.8%、95.7%和 91.7%。
结论
通过测量前半月板角、半月板体角和后半月板角，超声可可靠地诊断 DLM。
证据等级
III 级，病例对照研究。
Zotero 插件