超声对不同部位股骨关节面软骨退行性变的对比研究

目的探讨超声评价不同部位股骨关节面软骨退行性变的优劣。方法超声探查40例患者41个拟行关节镜手术或关节置换术的膝关节，均观察其股骨内髁、股骨外髁、股骨滑车正中沟、滑车内侧斜面和滑车外侧斜面，共计205个关节面。超声结果与手术所见对照。结果超声对滑车关节面病灶的诊断水平远远优于内、外髁，敏感性、特异性、准确性分别为：滑车中央沟76．9％、100％、92．5％；滑车内侧斜面96．0％、85．7％、91．3％；滑车外侧斜面65．2％、95．2％、79．5％；外髁54．5％、100％、70．6％；内髁50．0％、69．2％、54．7％。所有位于外髁负重面偏内侧和内髁负重面近髁间嵴的病灶，超声均未能显示。结论超声对股骨滑车软骨退行性变的诊断水平优于股骨髁，而外髁负重面偏内侧、内髁负重面偏髁间嵴区域是超声的扫查盲区。

Ultrasound Evaluation of Femoral Articular Cartilage Degeneration in Different Sites

Objective To evaluate the ultrasound role in the detection of femoral articular cartilages in different sites.Methods Forty patients (forty-one knees) who were to undergo arthroscopic surgery or complete knee arthroplasty were examined using high frequency ultrasound probe.Every knee joint was evaluated in 5 cartilage sites,and a total of 205 cartilages sites were examined.Ultrasonographic manifestations of articular cartilage were compared with results of arthroscopy and arthroplasty.Results The detection of cartilage abnormalities involved in the lateral femoral condyle (LFC) and medial femoral condyle (MFC),which was less accurate than those of the intercondylar groove (CIG),medial trochlear portion (MTP) and lateral trochlear portion (LTP).The sensitivities,specificities and accuracies of the 5 knee sites were as follows:CIG,76.9%,100%,92.5%;MTP,96.0%,85.7%,91.3%;LTP 65.2%,95.2%,79.5%;LFC,54.5%,100%,70.6%;MFC,50.0%,69.2%,54.7% respectively.All of the lesions in the medial portion of the LFC and the lateral portion of the MFC were not detected. Conclusions US is a more accurate and reliable modelity for detection of articular cartilage degeneration of the femoral trochlea than for femoral condyle.However,some areas including the medial portion of the LFC and the lateral portion of the MFC cannot be visible with US so called blind spots.