【摘要】 目的探讨创伤性膝关节积脂血症的超声表现与相关技术因素的关系。方法对52例单侧膝关节积脂血症患者在术前进行超声检查,均采用仰卧位,其中26例膝关节伸直位,16例下肢轻度外旋休息位,10例分别取膝关节伸直位和屈膝45°位检查;对22例行动态检查。以MRI或CT表现为金标准,将超声检查结果与其相对照。结果52例积脂血症均获正确诊断。超声检查积脂血症的最佳位置是髌上囊。仰卧膝关节伸直位显示最佳的是髌骨上缘,其次为髌骨水平,最差为髌骨以下水平。在少量积液时,最佳检查体位是仰卧屈膝45°位,优于膝关节伸直位,前者显示各层液体厚度大于后者,能显示少量液体及脂肪。下肢轻度外旋休息位时,三层液体常不能同时显示,须结合内外侧面才能确诊。动态检查液体由一层逐渐变为二层、三层,界面由模糊逐渐变清晰。结论关节积脂血症的超声表现与检查的位置、体位、制动时间密切相关。更多还原

【Abstract】 Objective To explore the correlation between ultrasonographic findings and relevant technical factors in traumatic lipohemarthrosis.Methods Fifty-two patients with traumatic lipohemarthrosis underwent ultrasonic examination in supine position(26 in unbent,16 in external rotary position,10 in unbent and 45° rotation)before operation,and 22 of them underwent dynamic examination.Findings of ultrasography were compared with manifestations of MRI and CT regarded as gold standard.Results Fifty-two patients with traumatic lipohemarthrosis were diagnosed correctly.The best effect of ultrasonic examination of lipohemarthrosis was observed on suprapatellar bursa.Superior border of patella were showed well in supine straight position,then turned to the level of patella,and the structure below patella were showed badly.The best posture was in supine genuflex position with 45° rotation when the joint effusion presented,by which thicker layer liquids could be displayed than in straight position.Three layer liquids could not be displayed synchronously in mild external rotary rest position of lower extremity,and the combination of findings at internal and external side were favorable to the diagnosis.Liquids bed changed from one layer to two layers and then to three layers,from fuzzy to clear gradually in dynamic examination.Conclusion Ultrasonic manifestations of traumatic lipohemarthrosis are closely correlated to the position,posture and arresting time during examination.更多还原