Evaluating Medial Meniscus Extrusion Under Different States With The Application Of Ultrasound And Its Effect

Objectives:The purpose of the study is to validate the semi-quantitative and quantitative ultrasound(US)evaluation of the extrusion of medial meniscus using MRI evaluation as a reference standard.On the other hand it is quite evident that ultrasound(US)can provide a more convenient,cost-effective,and practical auxiliary examination method for clinical diagnosis of medial meniscus extrusion(MME).Methods:In our study 50 patients(3 males and 47 females;average age 59±8 years)with chronic pain of knee joint as the chief complaint,who visited the Second Affiliated Hospital of Nanchang University from November 2021 to January 2023 were selected as participants in this study.After selection participants were advised to undergo ultrasound(US)and MRI examinations on the same day.Among the selected participants,20 patients underwent bilateral knee joint ultrasound(US)and MRI examinations.After completion of all imaging examinations the same group of musculoskeletal radiologists independently evaluated meniscus extrusion on ultrasound(US)and MRI,and semi-quantitatively graded it as follows:0(<3 mm),1(≥3 mm).Ultrasound(US)examination is divided into three body postures:a.Supine position b.Non-weight bearing standing position c.Weight-bearing standing position(with both hands carrying a weight of 2kg,each hand bearing a weight of 1kg).Our study focused to use MRI as a reference standard to evaluate the diagnostic value of ultrasound(US).Further,after obtaining all imaging data acquired from MRI and ultrasound(US)Prism6.0 application was put into use to evaluate the diagnostic performance of ultrasound(US).Besides,with the utilization of weighted kappa statistics we could analyze the consistency between ultrasound(US)and MRI evaluations.Further more,the intraclass correlation coefficient(ICC)was utilized to thoroughly evaluate the consistency of quantitative grading for our study.Results:The average of measurement results(in millimeters)of medial meniscus extrusion(MME)obtained:for supine MRI examination was(3.37±1.10)mm;for supine ultrasound examination was(3.44±1.58)mm;for non-weight bearing standing ultrasound examination was(3.49±1.62)mm;and for weight-bearing standing ultrasound examination was(4.45±2.19)mm.When using MRI as a reference standard,the evaluated accuracy rate of ultrasound(US)under the three different body postures was 89%,87%and 91%respectively.Among them,there was a significant difference noticed in ultrasound(US)results between the weight-bearing standing position and the supine MRI position(P<0.001).For semi-quantitative assessment,MRI had the best agreement with weight-bearing standing ultrasound(κ=0.80;95%CI,0.650.95),and a good agreement with supine ultrasound(κ=0.74;95%CI,0.58-0.91)and non-weight bearing standing ultrasound(κ=0.72;95%CI,0.55-0.88).As for quantitative assessment of ultrasound(US)with MRI as a reference standard,the intraclass correlation coefficient(ICC)for supine ultrasound and non-weight bearing ultrasound were 0.84(95%CI,0.75-0.90)and 0.74(95%CI,0.61-0.83)respectively.The three different body postures of knee joint ultrasound(US)conclusively have a good sensitivity value(86%;84%;90%)respectively and a specificity value(95%)in detecting the extrusion of medial meniscus.Conclusions:Patients with medial meniscus extrusion(MME)have stronger meniscus mobility.Therefore,our research results indicate that ultrasound(US)evaluation of medial meniscus extrusion(MME)exhibits excellent diagnostic performance in clinic.On the other hand ultrasound(US)is a more economical and convenient auxiliary examination method for detecting medial meniscus extrusion(MME),providing a new theoretical basis for subsequent clinical research.