Awan Fatima, Mondal Prosanta, van der Merwe Johannes M, Vassos Nicholas, Obaid Haron
College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada.
Clinical Research Support Unit, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada.
Healthcare (Basel). 2024 Oct 16;12(20):2051. doi: 10.3390/healthcare12202051.
BACKGROUND/OBJECTIVES: MRI is the gold standard for detecting meniscal tears; however, ultrasound may readily detect meniscal changes, obviating the need for MRI. We aim to (1) determine ultrasound sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in detecting meniscal changes, and (2) describe characteristic meniscal changes in US and their prevalence.
A retrospective analysis of knee ultrasound scans for the presence of medial and lateral meniscal tears was conducted. Meniscal changes were characterized into five US appearances (cleft, diminutive, cyst, displaced fragment, and extrusion) by the consensus of two musculoskeletal radiologists. Ultrasound findings were then compared to MRI results.
In total, 249 patients were included. Ultrasound sensitivity, specificity, PPV, NPV, and accuracy for medial meniscal tears were 79%, 97.3%, 95.3%, 86.6%, and 90%, respectively, and for lateral meniscal tears the ultrasound sensitivity, specificity, PPV, NPV, and accuracy were 63%, 99.5%, 96%, 93%, and 93.6%, respectively. The false negative and false positive rates for medial meniscal tears were 13.4% and 4.7%, respectively, and for the lateral meniscus, the false negative and false positive rates were 6.7% and 3.8%, respectively. Meniscal clefts were the most prevalent appearance in the medial meniscus followed by extrusions. Meniscal extrusions were the most prevalent appearance in the lateral meniscus followed by clefts.
Community-based US is highly accurate in the detection of meniscal tears when compared with MRI, making it a valuable diagnostic imaging tool for detecting meniscal tears in a community setting where accessibility to MRI is limited or if there are MRI contraindications.
背景/目的：磁共振成像（MRI）是检测半月板撕裂的金标准；然而，超声可能很容易检测到半月板的变化，从而无需进行MRI检查。我们旨在：（1）确定超声检测半月板变化的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性；（2）描述超声下半月板变化的特征及其发生率。
对膝关节超声扫描进行回顾性分析，以确定内侧和外侧半月板撕裂的存在情况。由两位肌肉骨骼放射科医生达成共识，将半月板变化分为五种超声表现（裂隙、微小、囊肿、移位碎片和挤出）。然后将超声检查结果与MRI结果进行比较。
共纳入249例患者。超声检测内侧半月板撕裂的敏感性、特异性、PPV、NPV和准确性分别为79%、97.3%、95.3%、86.6%和90%，检测外侧半月板撕裂的敏感性、特异性、PPV、NPV和准确性分别为63%、99.5%、96%、93%和93.6%。内侧半月板撕裂的假阴性率和假阳性率分别为13.4%和4.7%，外侧半月板的假阴性率和假阳性率分别为6.7%和3.8%。半月板裂隙是内侧半月板最常见的表现，其次是挤出。半月板挤出是外侧半月板最常见的表现，其次是裂隙。
与MRI相比，基于社区的超声在检测半月板撕裂方面具有高度准确性，使其成为在MRI可及性有限或存在MRI禁忌证的社区环境中检测半月板撕裂的有价值的诊断成像工具。
