四肢骨关节结核的超声和CT表现与手术结果的对比分析

目的通过四肢骨关节结核的超声和CT影像学表现与手术结果的对比分析,总结超声的运用价值。方法回顾性分析经手术治疗的35例四肢骨关节结核患者(共累及42个骨关节)资料,分别对超声和CT的影像学表现与手术结果进行符合率比较,根据符合率的高低,分段统计。结果42个四肢骨关节结核的影像学表现与手术结果符合率比较符合率≥100%超声表现有关节积液(脓)、周围软组织脓肿、窦道;CT表现骨质破坏、关节表面凹凸不平、周围软组织肿胀。80%≤符合率<100%超声有滑膜增厚;CT有游离死骨、关节间隙变窄。50%≤符合率<80%超声有游离死骨;CT有关节积液。20%≤符合率<50%超声有骨质破坏、周围软组织肿胀;CT有周围软组织脓肿、关节软骨破坏。0%≤符合率<20%超声有关节间隙变窄、关节软骨破坏;CT有滑膜增厚、窦道。结论在四肢骨关节结核术前的影像诊断方面,CT和超声检查各有优势,超声是CT检查的有效补充。

The comparative analysis of the ultrasound and CT image findings and surgical results in patients with tuberculosis of limbs

Objective To discuss the application value of ultrasound in tuberculosis of limbs through the comparative analysis of the ultrasound and CT image findings and surgical results.Methods 35 patients with tuberculosis of limbs who endured surgical therapy were analyzed restropectively.In this work,42 bone and joints were included.We compared the images findings of ultrasound and CT with surgical results respectively and then,made the partial statistics according to the different coincidence rates.Results In this work,the coincidence rates of image findings of 42 cases of tuberculosis of limbs were compared to those of the surgical results.In subjects that the coincidence rate was≥100,the ultrasound showed joint effusion(empyema),abscess and sinus in soft tissue and CT showed bone destruction,blurred joint surface,and swelling of soft tissue.In subjects that the coincidence rate was≥80%but<100%,the ultrasound showed thickening of synovium of joint and CT showed dissociated sequestrum and narrowing of joint space.In subjects that the coincidence rate was≥50%but<80%,Ultrasound showed dissociated sequestrum and CT showed joint effusion.In subjects that the coincidence rate was≥20%but c<50%,Ultrasound showed bone destruction,swelling of soft tissue and CT showed abscess in soft tissue,destruction of joint cartilage.In subjects that the coincidence rate was≥0%but<20%,Ultrasound showed narrowing of joint space,destruction of joint cartilage and CT showed thickening of synovium of joint,sinus tract.Conclusion As for the imaging diagnoses for patients with tuberculosis of limbs preoperatively,CT and Ultrasound have their own advantages,Ultrasound is an efficient complementary measure for CT.