| Objective: To investigate the feasibility and reproducibility of using shear wave elastic imaging in detecting the elastic characteristics of normal medial collateral ligament of knee joint.To explore the difference of elastic characteristics between normal and injured ligaments,and to further explore the anatomical basis of different elastic measurement values,which provides the basis for imaging diagnosis and treatment of medial collateral ligament injury of knee joint.Methods: We enrolled 76 cases of knee joint soft tissue,who were referred for ultrasound examination between April 2017 and February 2018 in Shenzhen No.2People's Hospital.According to the injury of the knee joint MCL,the subjects were included in the control group or the injury group.SWE technique was used to detect the mechanical characteristics of the superficial and deep layers of the ligaments at different sites.The data were recorded as followed,FCs,MCs and TCs.The effects of different parts of ligament,superficial and deep layers,left and right sides,sex and age on the elastic value of normal ligament were analyzed.The changes of elastic characteristics of injured ligament were analyzed.The results of MRI were taken as gold standard.The ROC curve was drawn to calculate the best value of SWE in the diagnosis of medial collateral ligament injury of the knee and to evaluate the value of SWE technique in the diagnosis of medial collateral ligament injury of knee joint.Results:(1)There were 76 subjects in the study,56 of whom were included in the control group according to the results of magnetic resonance imaging and surgery,and 20 in the injury group.The images were collected and analyzed successfully.The color of all the tested ligaments was evenly filled in the elastic sampling frame.The image quality is clear.(2)The velocity of shallow shear wave in normal MCL was higher than that in deep layer(P < 0.05).The velocity of shallow-deep shear wave in normal MCL was not significantly different from that in left and right,and there was no significant difference between male and female(P > 0.05).(3)There were significant differences in the superficial layer of FCs between ?50 years old group and < 30 years old group and 30~49 years old group(P < 0.05).There was a statistical difference between the MCs superficial layer and 30~49 years old group in ? 50 years old group(P < 0.05),and there was no statistical difference in all the measured values between the 30~49 years old group and the < 30 years old group.(4)There is a good internal consistency among the different measurements,and the consistency coefficient of each index is 0.834~0.963.(5)The knee MCL elastic image area not damage showed blue,blue mixed yellow or red and the knee MCL elastic image region lesions in blue or blue mixed green.(6)The MCL of the injured knee occurred at the end of the femur in the inputinjury group.Compared with the uninjured knee in the contralateral side,the shear wave velocities of MCL in the injured knee were lower than those in the control group(P < 0.01).(7)The optimal cutoff value of SWE for the diagnosis of superficial femoral injury in MCL is 3.040 m/s,the sensitivity and specificity are 80.00% and 90.00%.The best cut-off value for diagnosing deep injury of femur end of MCL is 2.750 m/s,and the sensitivity and specificity are 80.00% and 75.00%.Respectively,The area under the ROC curve of the superficial and deep layer of MCL is 0.948 and 0.909 respectively,which is proved the method has high accuracy.Conclusions:(1)Shear wave elastic imaging can quantitatively evaluate the intrinsic characteristics of medial collateral ligament of knee joint,which is feasible and reproducible.(2)Age is a factor that affects the elastic characteristics of medial collateral ligament of knee joint.With the increase of age,ligament hardness increases,but it has nothing to do with sex,left and right leg factors.(3)The incidence of MCL injury in the femur was higher,and the hardness of the injured ligament was lower.(4)Shear wave elastography is valuable in the diagnosis of medial collateral ligament injury of knee joint. |
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