The Comparative Study Of LFUS And MRI In Cruciate Ligament Injury

【Background And Objective】The knee joint is located in the lower limb and carry most of the weight of the body,it is one of the most vulnerable joint in the skeletal system.Cruciate ligament is an important component to maintain the stability of knee joint,and the incidence rate of injury in sports and traffic accidents is very high.If the cruciate ligament is injured without timely diagnosis and treatment,it will lead to a series of complications such as cartilage softening,osteoarthritis and osteoporosis.Surgical reconstruction is the main method for the treatment of cruciate ligament injury,and long-term rehabilitation exercise is required to play a better therapeutic effect.Timely treatment depends on the accurate diagnosis,the preoperative evaluation methods for cruciate ligament injury include physical examination of instability of knee joint,imaging examination and KT-1000 measurement instrument examination,etc.Currently,it mainly relies on imaging methods,especially MRI examination.Because of its high soft tissue resolution and contrast,it can clearly observe the ligament and the surrounding structure injury,it is considered as the gold standard for the diagnosis of this disease in imaging.However,its disadvantages are that the examination time is long and the examination cost is relatively high.When bilateral contrast scanis needed,the above disadvantages are more significant,and there are certain contraindications in this examine.In contrast,ultrasound has the advantages of non-invasive examination,dynamic observation,simple operation,economy and practicality,and it is easy to be popularized.There is neither ionizing radiation nor any contraindications in ultrasound examination.If the disease of cruciate ligament can be accurately diagnosed based on ultrasound,then ultrasound can be the first method to examine the injury of cruciate ligament.In view of the above background,this study adopts the LFUS systemic multi-directional scanning methods to investigate the cruciate ligament.Using arthroscopic results as the gold standard,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of LFUS and MRI were statistically analyzed and compared between the comparison groups,to explore the feasibility of LFUS imaging method for the systematic multi-directional scanning of cruciate ligament and its clinical application value in the diagnosis of cruciate ligament injury.【Methods】A total of 75 patients admitted to Foshan Hospital of Traditional Chinese Medicine from January 14,2019 to January 15,2020 with suspected cruciate ligament injury of unilateral knee joint were selected as research objects.The sonographer uses the LFUS method to investigate the injuries of ACL and PCL in the oblique sagittal position of anterior knee region,the cross-sectional position of popliteal fossa and the oblique sagittal position of popliteal fossa.The results of arthroscopic were used as the gold standard for the diagnosis of ACL and PCL injuries.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the results of LFUS and MRI were compared between groups,and the diagnostic effects of the two imaging methods was compared,so as to explore the feasibility and clinical application value of LFUS in the systematic multi-directional imaging scanning of the cruciate ligament.【Results】(1)55 cases of true positive,13 cases of true negative,5 cases of false positive and 2 cases of false negative were diagnosed by LFUS for ACL injury.And the accuracy,sensitivity,specificity,positive predictive value and negative predictive value were 90.67%,96.49%,72.22%,91.67% and86.67%,respectively.The accuracy,7 cases of true positive,64 cases of true negative,3 cases of false positive and 1 case of false negative were diagnosed by LFUS for PCL injury.And the accuracy,sensitivity,specificity,positive predictive value and negative predictive value were 94.67%,87.50%,95.52%,70.00% and 98.41%,respectively.(2)55 cases of true positive,14 cases of true negative,4 cases of false positive and 2 cases of false negative were diagnosed by MRI for ACL injury.And the accuracy,sensitivity,specificity,positive predictive value and negative predictive value were 92.00%,96.49%,77.78%,93.22%and 87.50%,respectively.The accuracy,7 cases of true positive,63 cases of true negative,4 cases of false positive and 1 case of false negative were diagnosed by MRI for PCL injury.And the accuracy,sensitivity,specificity,positive predictive value and negative predictive value were 93.33%,87.50%,94.03%,63.64% and 98.44%,respectively.(3)In the comparison between the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the two methods of LFUS and MRI on ACL and PCL injuries,the P values were all greater than0.05,indicating that there was no significant statistical difference between the two methods in the comparison of the above data results between the two comparison groups.【Conclusions】Both LFUS and MRI examination have high accuracy in the diagnosis of ACL and PCL injuries.Moreover,there were no significant statistical differences in the accuracy,sensitivity,specificity,positive predictive value andnegative predictive value between the comparison groups.It shows that ultrasonography has a good diagnostic value in cruciate ligament injury.LFUS can be used as the first choice of the methods for the detection of cruciate ligament injury.