A musculoskeletal ultrasound detection system and detection method for the lateral discoid meniscus of adolescents
By inputting measurement indicators into the muscular bone ultrasound detection system of the lateral disc meniscus of adolescents and comparing them with the threshold, the problem of single and experience-dependent measurement indicators in the prior art is solved, and the diagnosis of high sensitivity, specificity and accuracy is achieved, and a standardized measurement method is provided.
Patent Information
- Application Number
- CN202510486251.3
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- Filing Date
- 2025-04-17
- Publication Date
- 2025-07-29
- Estimated Expiration
- 2045-04-17
AI Technical Summary
The existing muscular ultrasound diagnosis technology has single measurement indicators in the diagnosis of lateral disc meniscus in adolescents, with low accuracy and specificity, and is highly dependent on the experience of the operator, making it difficult to achieve standardized measurements.
A muscular ultrasound detection system for the lateral disc-shaped meniscus in adolescents is provided. The measurement indicators such as meniscus width, thickness and angle are obtained through the input module, and compared with the preset threshold, and the diagnostic results are output, including the thickness thresholds of the anterior angle, body part and posterior angle of the meniscus, and the standardized surface bone structure positioning points are used for measurement.
The high sensitivity, specificity and accuracy diagnosis of the lateral disc meniscus in adolescents is achieved, and standardized measurement methods are provided, which reduces operator experience dependence and improves the reliability and consistency of the diagnosis.
Smart Images
Figure CN120000259B_ABST
Abstract
Description
Technical Field
[0001] The present invention belongs to the technical field of meniscus measurement, and particularly relates to a musculoskeletal ultrasound detection system and a detection method for adolescent lateral discoid meniscus. Background Art
[0002] The lateral discoid meniscus is the most common congenital lesion of the lateral meniscus. It refers to the abnormal enlargement and thickening of the lateral meniscus, which is approximately disk-shaped, a meniscus developmental anomaly, an abnormal structure within the knee joint, and can lead to knee osteoarthritis. The lateral discoid meniscus is relatively common in adolescents, and the incidence rate in the Asian population is higher than that in the West. Patients with lateral discoid meniscus may present with joint clicking, locking, pain, and limited movement. At the same time, they are prone to injuries such as meniscus tears and impacts during exercise, which is one of the common causes of sports injuries in adolescents. Therefore, early diagnosis of the lateral discoid meniscus is a prerequisite for timely and effective treatment.
[0003] Musculoskeletal ultrasound has developed into a highly valuable tool in the field of meniscus pathological diagnosis. In recent years, the progress of high-frequency probes and high-resolution imaging technology has significantly improved the ability of ultrasound in diagnosing meniscus injuries and abnormalities. As a non-invasive imaging method, ultrasound examination offers multiple advantages, including low cost, simple operation, real-time dynamic evaluation, and strong accessibility. Research shows that in some meniscus pathological diagnoses, ultrasound examination can now achieve a sensitivity and specificity level comparable to magnetic resonance imaging (MRI).
[0004] Musculoskeletal ultrasound has also made remarkable progress in the field of discoid meniscus diagnosis. Recent research shows that high-resolution ultrasound has shown potential in diagnosing discoid meniscus, especially in the diagnosis of lateral discoid meniscus, showing high sensitivity and specificity. The advantage of ultrasound is its ability to dynamically observe the movement of the meniscus, which is particularly important for the diagnosis of discoid meniscus. In existing studies on the musculoskeletal ultrasound diagnosis of adult lateral discoid meniscus injuries, the diagnosis is mainly based on morphological indicators, such as whether there are abnormal corners or jams under ultrasound, and measuring the thickness of the synovial margin of the meniscus / discoid meniscus, and its diagnostic efficacy is verified by comparing with MRI or arthroscopic examination.
[0005] The existing musculoskeletal ultrasound diagnosis technology for meniscus still mainly relies on the guidance of books in the professional field of musculoskeletal ultrasound, and still has important guiding value in elements such as body position placement and probe placement. In "Musculoskeletal Ultrasound Diagnosis (Editor-in-Chief: Wang Yuexiang, Qu Wenchun)", the patient adopts the supine position, and a small pillow is placed behind the knee to make the knee joint flex 20 - 30° for measurement (such as Figure 1). The book does not introduce the measurement of the lateral meniscus. When measuring the medial meniscus, the knee joint is slightly valgus, and the probe is placed between the medial femoral condyle and the tibial plateau. By moving the probe back and forth, the anterior horn, body, and posterior horn of the meniscus can be displayed. In addition, "Abdominal and Superficial Tissue Color Doppler Ultrasound" also mentions that when performing ultrasound examinations on the medial and lateral sides of the knee joint, the anterior and posterior horn regions of the medial and lateral menisci of the knee joint can be scanned respectively (such as Figure 2 ).
[0006] In the diagnosis of discoid meniscus in adolescents, ultrasound examination has been proven to be an effective preliminary screening tool, which helps to reduce long-term MRI examinations. However, there are relatively few musculoskeletal ultrasound diagnoses of discoid meniscus in children and adolescents. Yang Hua et al. compared whether there are differences in the diagnostic efficacy of different musculoskeletal ultrasound probes for the lateral discoid meniscus in adolescents, and their ultrasound measurement indicators only include the meniscus / discoid meniscus width. Therefore, there are still some limitations in the ultrasound diagnosis of discoid meniscus in adolescents: (1) The measurement indicators are single, and the accuracy or specificity is not high. Especially in some complex cases such as those involving muscle, ligament, and multiple soft tissue injuries, MRI may be required for confirmation; (2) The measurement methods are not unified and highly dependent on the operator's experience.
[0007] In summary, how to select appropriate parameters for measurement to make the musculoskeletal ultrasound method more accurately diagnose discoid meniscus in adolescents is a major challenge in this field. Summary of the Invention
[0008] Aiming at the defects of the prior art, the present invention provides a musculoskeletal ultrasound measurement method for the lateral discoid meniscus in adolescents, aiming to accurately perform ultrasound examinations on the meniscus / discoid meniscus in adolescents.
[0009] The present invention provides a musculoskeletal ultrasound detection system for the lateral discoid meniscus in adolescents, which includes:
[0010] An input module, configured to input measurement indicators, where the measurement indicators include at least one of meniscus width, meniscus thickness, meniscus median thickness, and meniscus angle;
[0011] A comparison module, configured to compare the data of the measurement indicators with thresholds, and the thresholds are respectively: when the knee is flexed at 30°, the threshold for the anterior horn thickness of the meniscus is 0.78 cm, the threshold for the anterior horn median thickness of the meniscus is 0.36 cm, the threshold for the body thickness of the meniscus is 0.80 cm, the threshold for the body median thickness of the meniscus is 0.41 cm, the threshold for the posterior horn thickness of the meniscus is 0.67 cm, and the threshold for the posterior horn median thickness of the meniscus is 0.35 cm; when the knee is flexed at 90°, the threshold for the anterior horn thickness of the meniscus is 0.76 cm, and the threshold for the anterior horn median thickness of the meniscus is 0.32 cm;
[0012] The output module is configured to output the lateral discoid meniscus if at least one of the data of the measurement indicators is greater than or equal to the threshold value, and output the normal meniscus if any of the data of the measurement indicators is less than the threshold value.
[0013] Preferably, the measurement indicator is the meniscus thickness and / or the median meniscus thickness.
[0014] Preferably, the detection method of the measurement indicator is as follows: the leg to be measured of the subject is in the upper lateral position, with the knee flexed at 30°, 60°, and 90° respectively, and the data of the measurement indicator is detected in the examination area through a musculoskeletal ultrasound detection system. The examination area includes the anterior horn, body, and posterior horn of the meniscus.
[0015] Preferably, the knee flexion is 30° and 90°; the measurement indicator is the meniscus thickness and / or the median thickness.
[0016] Preferably, the positions of the anterior horn, body, and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head, and the popliteal tendon groove of the lateral femoral condyle.
[0017] Preferably, the examination area of the anterior horn of the meniscus is located in the area where the extension line of the long axis of the lateral margin of the patella intersects the joint line of the tibiofemoral joint;
[0018] and / or, the examination area of the body of the meniscus is located in the area where the tangent line along the long axis in front of the fibular head intersects the joint line of the tibiofemoral joint;
[0019] and / or, the examination area of the posterior horn of the meniscus is located in the area where the tangent line along the long axis behind the fibular head intersects the joint line of the tibiofemoral joint.
[0020] Preferably, the leg to be measured is slightly internally rotated before knee flexion;
[0021] and / or, during the detection, the examiner performs the measurement on the right side of the subject;
[0022] and / or, the age of the subject is 10 - 19 years old.
[0023] Preferably, during the detection, the examiner performs a standard section examination according to the existing examination method of the musculoskeletal ultrasound of the knee joint; when performing the lateral knee joint ultrasound examination, the ultrasound probe is placed along the long axis of the lower limb; when measuring the posterior horn of the meniscus, the ultrasound probe is placed at the posterolateral side.
[0024] Preferably, the meniscus width is the distance from the top to the bottom of the white triangular area of the meniscus in the ultrasound image; the meniscus thickness is the distance between the two edges where the white triangular area of the meniscus is connected to the synovial margin in the ultrasound image; the median meniscus thickness is the meniscus thickness at the 1 / 2 of the meniscus width; the meniscus angle is the included angle formed by the tangent line of the part of the meniscus close to the center of the joint cavity.
[0025] The present invention provides a detection method using the musculoskeletal ultrasound detection system described in any of the above for non-diagnostic purposes, which includes:
[0026] Inputting measurement indicators, where the measurement indicators include at least one of meniscus width, meniscus thickness, median meniscus thickness, and meniscus angle;
[0027] Comparing the data of the measurement indicators with thresholds, where the thresholds are respectively: at 30° of knee flexion, the threshold for the anterior horn thickness of the meniscus is 0.78 cm, the threshold for the median anterior horn thickness of the meniscus is 0.36 cm, the threshold for the body thickness of the meniscus is 0.80 cm, the threshold for the median body thickness of the meniscus is 0.41 cm, the threshold for the posterior horn thickness of the meniscus is 0.67 cm, and the threshold for the median posterior horn thickness of the meniscus is 0.35 cm; at 90° of knee flexion, the threshold for the anterior horn thickness of the meniscus is 0.76 cm, and the threshold for the median anterior horn thickness of the meniscus is 0.32 cm;
[0028] If at least one of the data of the measurement indicators is greater than or equal to the threshold, output as a lateral discoid meniscus; if any of the data of the measurement indicators is less than the threshold, output as a normal meniscus.
[0029] The present invention provides a musculoskeletal ultrasound detection system and its detection method for the lateral discoid meniscus in adolescents. By screening the knee flexion angles (30°, 60°, 90°) of the legs of the subjects to be tested, the examination regions (anterior horn, body, posterior horn of the meniscus), and the measurement indicators (meniscus width, meniscus free edge angle, meniscus thickness, and median meniscus thickness), the present invention has optimized a musculoskeletal ultrasound diagnosis method suitable for the lateral discoid meniscus in adolescents. The optimized musculoskeletal ultrasound diagnosis method has high sensitivity, specificity, and accuracy. The present invention proposes clear surface bony structure positioning points, which can standardize the measurement and avoid selection biases and other situations that may occur when different operators select the anterior horn, body, or posterior horn. The method of the present invention provides a strong basis for the clinical diagnosis and early detection of the lateral discoid meniscus in adolescents and has good application prospects.
[0030] Obviously, based on the above content of the present invention, according to the common general knowledge and customary means in the art, without departing from the above basic technical idea of the present invention, various other forms of modifications, substitutions, or changes can be made.
[0031] The following is a further detailed description of the above content of the present invention through specific embodiments in the form of examples. However, this should not be construed as limiting the scope of the above subject matter of the present invention to the following examples. All technologies implemented based on the above content of the present invention fall within the scope of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS
[0032] Figure 1 It is a schematic diagram of the ultrasonic imaging of the medial meniscus and tibial collateral ligament of the knee joint in the book "Musculoskeletal Ultrasound Diagnosis"; among them, the long arrow indicates the ultrasonic imaging diagram of the medial meniscus of the knee joint; the short arrow indicates the ultrasonic imaging diagram of the tibial collateral ligament.
[0033] Figure 2 It is a schematic diagram of the ultrasonic imaging of the meniscus of the knee joint in the book "Color Doppler Ultrasound of the Abdomen and Superficial Tissues"; among them, Figure A is a schematic diagram of the ultrasonic imaging of the medial meniscus of the knee joint, and the arrow indicates the triangular area of the meniscus; Figure B is a schematic diagram of the ultrasonic imaging of the lateral meniscus of the knee joint, and the arrow indicates the triangular area of the meniscus.
[0034] Figure 3 It is a schematic diagram of the body position placement when the knee is flexed; among them, Figure A is a schematic diagram of the body position placement when the knee is flexed at 30°; Figure B is a schematic diagram of the body position placement when the knee is flexed at 60°; Figure C is a schematic diagram of the body position placement when the knee is flexed at 90°.
[0035] Figure 4 It is a schematic diagram of the positioning of the ultrasonic probe during the musculoskeletal ultrasound examination of the lateral meniscus / discoid meniscus of the knee joint; among them, 1 is the indication diagram of the tibiofemoral joint line; 2 is the indication diagram of the patella; 3 is the indication diagram of the fibular head; 4 is the indication diagram of the tangent line of the outer edge of the patella; 5 is the indication diagram of the tangent line along the long axis in front of the fibular head; 6 is the indication diagram of the posterolateral tangent line of the fibular head; 7 is the indication diagram of the measurement area of the anterior horn of the lateral meniscus; 8 is the indication diagram of the measurement area of the body of the lateral meniscus; 9 is the indication diagram of the measurement area of the posterior horn of the lateral meniscus.
[0036] Figure 5 It is a schematic diagram of the measurement indexes when measuring the lateral meniscus / discoid meniscus of the knee joint by musculoskeletal ultrasound; among them, Figure a is a schematic diagram of the measurement indexes 1: meniscus thickness, 2: median meniscus thickness, 3: meniscus width; Figure b is a schematic diagram of the measurement index 4: meniscus angle.
[0037] Figure 6 It is an ultrasonic scan diagram of the normal body of the meniscus when the knee is flexed at 30°.
[0038] Figure 7 It is an ultrasonic scan diagram of the normal anterior horn of the meniscus when the knee is flexed at 30°.
[0039] Figure 8 It is an ultrasonic scan diagram of the body of the lateral discoid meniscus of four patients when the knee is flexed at 30°; among them, Figure A is an ultrasonic scan diagram of the lateral discoid meniscus (undamaged) of Patient A; Figure B is an ultrasonic scan diagram of the lateral discoid meniscus (undamaged) of Patient B; Figure C is an ultrasonic scan diagram of the lateral discoid meniscus (damaged) of Patient C; Figure D is an ultrasonic scan diagram of the lateral discoid meniscus (damaged) of Patient D; the arrow indicates the torn part. Detailed implementation mode
[0040] In the following examples and experimental examples, reagents and materials not specifically stated are commercially available products.
[0041] In the present invention, a domestic color Doppler ultrasound diagnostic instrument (product model: LOGIQ e) is used. The examination uses a linear array probe, the probe frequency is 2.0 - 5.0 MHz, the c1 - 5 probe is used, the examination mode is B - mode, and the musculoskeletal mode of this instrument is uniformly adopted for examination of the knee joint. Images are collected twice for all examinations, and the images are stored and measured.
[0042] Example 1 A musculoskeletal ultrasound detection method for the lateral discoid meniscus in adolescents
[0043] In this example, an examination process and plan for the lateral discoid meniscus in adolescents are established. The detailed steps are as follows:
[0044] I. Body position placement
[0045] As Figure 3 shown, the patient lies on the side with the affected side on top, the healthy leg is flexed to maintain the stability of the lateral lying position, the affected leg is slightly internally rotated, and measurements are taken at 30° and 90° of knee flexion respectively. When the patient's knee is flexed at 90°, a cushion is placed under the affected side.
[0046] II. Confirmation of surface landmarks
[0047] Use bony landmarks for positioning. As Figure 4 shown, the anterior horn, body, and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head, and the popliteal tendon groove of the lateral femoral condyle. The examination area of the anterior horn of the lateral meniscus is located in the area where the long - axis extension line of the lateral margin of the patella intersects the tibio - femoral joint line; the body examination area is located in the area where the long - axis tangent line in front of the fibular head intersects the joint line; the posterior horn examination area is located in the area where the long - axis tangent line behind the fibular head intersects the joint line.
[0048] III. Confirmation of examination indicators
[0049] The examination indicators include the meniscus thickness (cm) and the median meniscus thickness (cm). As Figure 5 shown, the meniscus thickness is the distance between the two edges where the white triangle is connected to the synovial margin in Figure 5 ; the median meniscus thickness is the meniscus thickness at the 1 / 2 width of the meniscus, and the meniscus width is the distance from the top to the bottom of the white triangle in Figure 5 .
[0050] V. Measurement method
[0051] The examiner conducts the examination on the right side of the patient and performs standard cross-section examinations according to the existing musculoskeletal ultrasound knee examination method. When performing the lateral knee ultrasound examination, the ultrasound probe usually uses a long-axis sonogram (i.e., coronal imaging, with the ultrasound probe placed along the long axis of the lower limb) for structural examination. When measuring the posterior horn of the meniscus, the probe should be placed at the posterolateral side.
[0052] VI. Diagnosis of Lateral Discoid Meniscus
[0053] (1) Qualitative evaluation
[0054] The normal lateral meniscus shows isoechoic signals and uniform echoes. When the meniscus is damaged, there is a strip-shaped hypoechoic area inside the meniscus.
[0055] The discoid meniscus is thicker and wider in shape than the normal meniscus. In ultrasound imaging, the image of the lateral discoid meniscus is trapezoidal or irregular quadrilateral, while the normal meniscus is triangular with uniform signals.
[0056] (2) Quantitative evaluation
[0057] At 30° knee flexion, the threshold for the anterior horn thickness of the meniscus is 0.78 cm, the threshold for the median anterior horn thickness of the meniscus is 0.36 cm, the threshold for the body thickness of the meniscus is 0.80 cm, the threshold for the median body thickness of the meniscus is 0.41 cm, the threshold for the posterior horn thickness of the meniscus is 0.67 cm, and the threshold for the median posterior horn thickness of the meniscus is 0.35 cm.
[0058] At 90° knee flexion: the threshold for the anterior horn thickness of the meniscus is 0.76 cm, and the threshold for the median anterior horn thickness of the meniscus is 0.32 cm.
[0059] If the test result of any of the above indicators exceeds the threshold, it indicates a risk of having a lateral discoid meniscus; the more test indicators that exceed the threshold, and / or the higher the degree of exceeding the threshold, the higher the risk of having a lateral discoid meniscus.
[0060] Example 2 Use of the musculoskeletal ultrasound detection system for the lateral discoid meniscus in adolescents for non-diagnostic purposes
[0061] The menisci of adolescent volunteers are detected according to the detection method described in Example 1 to develop knee braces more suitable for adolescents with discoid menisci.
[0062] Example 3 Use of the musculoskeletal ultrasound detection system for the lateral discoid meniscus in adolescents for non-diagnostic purposes
[0063] The menisci of adolescent volunteers are detected according to the detection method described in Example 1 to prepare 3D printed meniscus models for teaching purposes.
[0064] The technical solution of the present invention will be further described through experiments below.
[0065] Experimental Example 1 Screening of Measurement Indexes of Musculoskeletal Ultrasound Method
[0066] I. Experimental Method
[0067] (1) Body Position Placement
[0068] The patient lies on the side with the affected side on top, the healthy leg is flexed, the side-lying position is maintained stable, the affected leg is slightly internally rotated, and measurements are taken at 30°, 60°, and 90° of knee flexion respectively (as Figure 3 ), and a cushion is placed under the affected side when the patient's knee is flexed at 90°. The examiner is located on the right side of the patient for examination, and the examiner performs standard section examinations according to the existing musculoskeletal ultrasound knee examination method. When performing ultrasound examination of the lateral knee joint, the ultrasound probe usually uses a long-axis sonogram (i.e., coronal imaging, and the ultrasound probe is placed along the long axis of the lower limb) for structural examination. The basic structures of the lateral knee joint include the lateral collateral ligament, iliotibial tract, biceps femoris tendon, and lateral meniscus.
[0069] (2) Confirmation of Body Surface Markers
[0070] During the examination process, bony markers are used for positioning, and the anterior horn, body, and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, fibular head, and popliteal tendon groove of the lateral femoral condyle. The examination area of the anterior horn of the lateral meniscus is located in the area where the long-axis extension line of the lateral edge of the patella intersects the joint line of the tibiofemoral joint; the body examination area is located in the area where the long-axis tangent in front of the fibular head intersects the joint line; the posterior horn examination area is located in the area where the long-axis tangent behind the fibular head intersects the joint line (as Figure 4 ).
[0071] (3) Confirmation of Scanned Images
[0072] The normal lateral meniscus shows an isoechoic signal and the echo is uniform. When the meniscus is damaged, a strip-shaped hypoechoic area can be seen inside the meniscus. When measuring the body of the normal lateral meniscus, there may be uneven echo, which is caused by the influence of the lateral femoral condyle. The probe should be finely adjusted and imaged multiple times to distinguish it from the damage. In addition, when measuring the posterior horn of the meniscus, the probe should be placed at the posterolateral side, and due to the presence of the popliteal tendon and the posterior recess of the joint between the middle and posterior parts of the lateral meniscus and the joint capsule, the probe should be finely adjusted and imaged multiple times to distinguish the hypoechoic area between the meniscus and the joint capsule from the meniscus damage.
[0073] (4) Confirmation of Ultrasound Image Indexes
[0074] The examination indexes include meniscus width (cm), meniscus thickness (cm), median meniscus thickness (cm), and meniscus angle (°). Among them, the meniscus width is Figure 5The distance from the top to the bottom of the white triangle in the middle; the meniscus thickness is the distance between the two edges where the white triangle is connected to the synovial margin; the median meniscus thickness is the meniscus thickness at the 1 / 2 of the meniscus width, and the meniscus angle is the included angle formed by the tangent line of the part of the meniscus close to the center of the joint cavity.
[0075] (5)Measurement method
[0076] Each index was measured 3 times and the average value was taken. All indexes were measured twice by the same person, and the interval between the two measurements was 1 month. The consistency analysis was performed on the data of the two measurements. If the obtained consistency was good, the analysis could continue. If the consistency difference was large, the third measurement was performed after one month. All images and data were saved.
[0077] (6)Test population
[0078] The test population was from the population with suspected lateral meniscus injury in the Sports Medicine Center of West China Hospital, aged 4 - 19 years old, with a total of 60 cases.
[0079] (7)Data processing method
[0080] The collected data was statistically analyzed using SPSS 23.0 (Statistical Product and Service Solutions) software. Continuous variables were recorded in the form of mean ± standard deviation, and discontinuous variables were recorded in terms of the number of cases or percentages. The measurement indexes were continuously measured twice. The diagnostic value analysis was performed by plotting the ROC curve to calculate the threshold and recording its AUC area. The diagnostic indexes included diagnostic accuracy, sensitivity, and specificity. Accuracy evaluated the percentage of the number of true positives and true negatives diagnosed in the total number, sensitivity evaluated the percentage of the number of truly diseased cases diagnosed in the actual number of truly diseased cases, and specificity evaluated the percentage of the number of truly healthy cases diagnosed in the actual number of truly healthy cases.
[0081] II. Experimental results
[0082] (1)Qualitative evaluation
[0083] The discoid meniscus is thicker and wider in shape than the normal meniscus. In ultrasonic imaging, the normal meniscus is mostly a triangle with uniform signal (such as Figure 6 、 7 ); there are differences in the width, thickness, included angle, etc. of the discoid meniscus from the normal lateral meniscus. Compared with the normal meniscus, the image of the lateral discoid meniscus is trapezoid or irregular quadrilateral (such as Figure 8 ).
[0084] (2)Quantitative results
[0085] The AUC and threshold results of the measurement indicators are shown in Table 1: When the knee is flexed at 30°, the measurement indicators with AUC values greater than 0.7 are: the meniscus thickness, median thickness measured in the anterior horn, body, and posterior horn examination areas, and the meniscus width measured in the posterior horn examination area; When the knee is flexed at 60°, the measurement indicator with an AUC value greater than 0.7 is: the median meniscus thickness measured in the body examination area; When the knee is flexed at 90°, the measurement indicators with AUC values greater than 0.7 are: the meniscus thickness, median thickness, and included angle measured in the anterior horn examination area. It shows that under these selected measurement indicators and corresponding thresholds, normal menisci and lateral discoid menisci can be identified more accurately.
[0086] Table 1 AUC and threshold results of measurement indicators
[0087]
[0088] The sensitivity, specificity, and accuracy results are shown in Table 2. It can be seen that the measurement indicators with sensitivity, specificity, and accuracy all greater than 65% are: When the knee is flexed at 30°, the meniscus thickness and median thickness measured in the anterior horn, body, and posterior horn examination areas. It shows that under these measurement indicators according to the measurement method of the present invention, better results of sensitivity, specificity, and accuracy can be obtained, which can provide a reliable diagnostic basis for doctors. Among them, the measurement indicators with sensitivity, specificity, and accuracy all greater than 75% are: When the knee is flexed at 30°, the meniscus thickness measured in the anterior horn examination area. It shows that this measurement indicator has higher diagnostic value.
[0089] Table 2 Sensitivity, specificity, and accuracy results of measurement indicators
[0090]
[0091] In addition, in the field of medical diagnosis, specificity is of extremely important significance and can reduce misdiagnosis and improve the reliability of diagnosis. Therefore, the present invention also screens out measurement indicators with relatively high specificity (exceeding 80%), which are respectively: When the knee is flexed at 30°, the meniscus width measured in the anterior horn examination area, the meniscus included angle measured in the body examination area, the meniscus thickness and included angle measured in the posterior horn examination area; When the knee is flexed at 60°, the median meniscus thickness measured in the body examination area; When the knee is flexed at 90°, the meniscus thickness and median thickness measured in the anterior horn examination area.
[0092] Based on the above screening results of AUC, sensitivity, specificity, and accuracy, the measurement indicators with high diagnostic value are: the meniscus thickness and median thickness measured in the anterior horn, body, and posterior horn examination areas when the knee is flexed at 30°. Among them, particularly, when the knee is flexed at 30°, using the meniscus thickness measured in the anterior horn examination area as the indicator yields the best results in all aspects, providing a reliable basis for the diagnosis of lateral discoid meniscus in adolescents. Considering high specificity additionally, when the knee is flexed at 90°, the two measurement indicators of the meniscus thickness and median thickness measured in the anterior horn examination area also have high diagnostic value.
[0093] Since there are situations such as changes in knee flexion angle and continuous movement during the measurement of underage patients, the diagnostic value of the measurement indicators at 60° of knee flexion still needs further research. For the measurement indicators at 90° of knee flexion, their sensitivity is low, but the specificity and accuracy are high, possibly due to muscle compression caused by excessive knee flexion, which affects the probe imaging. Therefore, when performing musculoskeletal ultrasound diagnosis and measurement of lateral discoid meniscus in adolescents, it is preferred to fully incorporate the detection information of the thickness and median thickness measured in the anterior horn, body, and posterior horn of the meniscus in the knee flexion 30° position, combined with the detection information of the thickness and median thickness measured in the anterior horn in the knee flexion 90° position.
[0094] The above results indicate that during the musculoskeletal ultrasound diagnosis of lateral discoid meniscus in adolescents, the present invention has screened out examination indicators with high sensitivity, specificity, and accuracy, and determined the thresholds of the examination indicators.
[0095] From the above-mentioned examples and experimental examples, it can be seen that the present invention provides a musculoskeletal ultrasound detection system and its detection method for lateral discoid meniscus in adolescents. The present invention conducts multi-position measurement and evaluation at knee flexion angles of 30°, 60°, and 90° respectively, in the lateral lying position, to analyze the musculoskeletal ultrasound imaging under different conditions where the surrounding structures cause different degrees of compression on the meniscus at different knee flexion angles; the present invention incorporates morphological indicators, meniscus width, meniscus free edge angle, meniscus thickness, and meniscus median thickness, and measures all quantitative indicators at the anterior horn, body, and posterior horn of the meniscus / discoid meniscus respectively, providing detailed multi-plane data; the present invention proposes clear surface bony structure positioning points, which can standardize the measurement and avoid selection biases and other situations when different operators select the anterior horn, body, or posterior horn. Through the calculation and comparison of the detection data, quantitative examination indicators suitable for the musculoskeletal ultrasound diagnosis of lateral discoid meniscus in adolescents are selected, providing a strong basis for the clinical diagnosis and early detection of lateral discoid meniscus in adolescents, and having good application prospects.
Claims
1. An osteo-muscle ultrasound detection system for the lateral discoid meniscus of adolescents, characterized in that, Comprising: An input module configured to input measurement indicators, where the measurement indicators include at least one of meniscus thickness and meniscus median thickness; A comparison module configured to compare the data of the measurement indicators with thresholds, where the thresholds are respectively: at 30° of knee flexion, the threshold for the anterior horn thickness of the meniscus is 0.78 cm, the threshold for the anterior horn median thickness of the meniscus is 0.36 cm, the threshold for the body thickness of the meniscus is 0.80 cm, the threshold for the body median thickness of the meniscus is 0.41 cm, the threshold for the posterior horn thickness of the meniscus is 0.67 cm, and the threshold for the posterior horn median thickness of the meniscus is 0.35 cm; An output module configured to output a lateral discoid meniscus if at least one of the data of the measurement indicators is greater than or equal to the threshold, and output a normal meniscus if any of the data of the measurement indicators is less than the threshold.
2. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 1, wherein: The detection method of the measurement indicators is as follows: The leg to be measured of the subject is in the upper lateral position, with the knee flexed at 30°, and the data of the measurement indicators are detected in the examination area through a musculoskeletal ultrasound detection system, where the examination area includes the anterior horn, body, and posterior horn of the meniscus.
3. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 2, wherein: The positions of the anterior horn, body, and posterior horn of the meniscus are located according to the Gerdy tubercle of the tibia, the fibular head, and the popliteal tendon groove of the lateral femoral condyle.
4. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 3, characterized in that: The examination area of the anterior horn of the meniscus is located in the intersection area of the extension line of the long axis of the lateral margin of the patella and the joint line of the tibiofemoral joint; And / or, the examination area of the body of the meniscus is located in the intersection area of the tangent line along the long axis in front of the fibular head and the joint line of the tibiofemoral joint; And / or, the examination area of the posterior horn of the meniscus is located in the intersection area of the tangent line along the long axis behind the fibular head and the joint line of the tibiofemoral joint.
5. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 2, characterized in that: The leg to be measured is slightly internally rotated before knee flexion; And / or, during the detection, the examiner performs the measurement on the right side of the subject; And / or, the age of the subject is 10 - 19 years old.
6. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 2, wherein: During the detection, the examiner performs standard section examination according to the existing examination method of musculoskeletal ultrasound of the knee joint; when performing lateral knee joint ultrasound examination, the ultrasound probe is placed along the long axis of the lower limb; when measuring the posterior horn of the meniscus, the ultrasound probe is placed at the posterolateral side.
7. The musculoskeletal ultrasound detection system for the lateral discoid meniscus of adolescents according to claim 1, characterized in that: The meniscus width is the distance from the top to the bottom of the white triangular area of the meniscus in the ultrasound image; the meniscus thickness is the distance between the two edges where the white triangular area of the meniscus is connected to the synovial margin; the meniscus median thickness is the meniscus thickness at the 1 / 2 of the meniscus width; the meniscus angle is the included angle formed by the tangent of the part of the meniscus close to the center of the joint cavity.