Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
Pediatr Radiol. 2023 Nov;53(12):2380-2385. doi: 10.1007/s00247-023-05777-5. Epub 2023 Sep 29.
MR arthrography is an essential diagnostic tool to assess and guide management of labral, ligamentous, fibrocartilaginous, and capsular abnormalities in children. While fluoroscopy is traditionally used for intra-articular contrast administration, ultrasound offers advantages of portability and lack of ionizing radiation exposure for both the patient and proceduralist.
The purpose of this retrospective study is to quantify technical success and frequency of complications of ultrasound-guided arthrogram injections at our institution.
This retrospective analysis investigates the results of 217 ultrasound-guided arthrograms of the shoulder, elbow, and hip in patients aged 5-18 years. Successful injection of contrast into the target joint, clinical indication for MR arthrography, and complications were reviewed.
Accurate ultrasound-guided intra-articular administration of contrast into the target joint was successful for 100% of shoulder cases (90/90), 97% of elbow cases (77/79), and 98% of hip cases (47/48). Leak of contrast outside the target joint occurred in 1.4% (3/217) of cases. No major side effects including excessive bleeding, paresthesia, allergic reactions, or infection occurred during or after the procedure. Additionally, no major vessel, nerve, or tendon complications were observed on MR images.
Ultrasound guidance is a reliable, effective, and safe approach to arthrography in children.
磁共振关节造影术是评估和指导儿童盂唇、韧带、纤维软骨和关节囊病变的重要诊断工具。虽然传统上使用透视法进行关节内对比剂给药，但超声具有便携性和对患者及操作人员无电离辐射暴露的优势。
本回顾性研究旨在量化我院超声引导关节造影注射的技术成功率和并发症发生率。
本回顾性分析调查了 217 例年龄在 5-18 岁的患者的肩部、肘部和髋关节超声引导关节造影的结果。对造影剂成功注入目标关节、磁共振关节造影的临床适应证和并发症进行了回顾。
100%（90/90）的肩部病例、97%（77/79）的肘部病例和 98%（47/48）的髋关节病例准确地进行了超声引导下的关节内对比剂注射。1.4%（3/217）的病例发生对比剂漏出到目标关节外。在操作过程中和操作后，没有出现包括过度出血、感觉异常、过敏反应或感染在内的严重副作用。此外，磁共振图像上未观察到主要血管、神经或肌腱并发症。
超声引导是儿童关节造影术的一种可靠、有效且安全的方法。
