ABSTRACT
ABSTRACT Objective: To determine the value of ultrasonography in elbow ligament assessment compared to magnetic resonance imaging. Methods: A prospective single-center study involving 30 volunteers with no elbow joint changes. Two experienced ultrasound specialists evaluated both elbows of each volunteer, resulting in 60 evaluations per physician and totaling up 120 evaluations. Magnetic resonance images were obtained using a 3-Tesla machine and evaluated by two experienced radiologists, totaling up 120 exams. Each examiner assigned subjective, zero-to-5 scores to ligaments imaged, where zero corresponded to non-identified ligament and 5 to visualization of the entire ligament. The level of significance was set at 5%. Bland-Altman dispersions and plots were prepared for each pair of measurements obtained. Results: All ligaments were amenable to sonographic identification; scores of 4 or 5 were assigned by examiners based on ligament visibility. Ligaments could also be identified using magnetic resonance imaging and were assigned scores of 5 by examiners. All ligaments were described as intact and healthy by all four examiners. Comparative analysis of elbow ligament sonographic and magnetic resonance imaging findings did not differ significantly. Conclusion: Ultrasonography and magnetic resonance imaging can be considered equivalent modalities for elbow ligament assessment in the hands of experienced examiners.
RESUMO Objetivo: Avaliar o desempenho da ultrassonografia na avaliação dos ligamentos do cotovelo, comparando os achados com ressonância magnética. Métodos: Estudo prospectivo unicêntrico envolvendo 30 pacientes, sem alterações articulares nos cotovelos. Dois ultrassonografistas experientes avaliaram ambos os cotovelos de cada um dos pacientes, com 60 avaliações cada médico e 120 avaliações no total. As imagens de ressonância magnética foram obtidas em aparelhos 3 Tesla. Dois radiologistas experientes avaliaram as imagens, com total de 120 exames. Cada examinador deu uma nota subjetiva, de zero a 5, para os ligamentos avaliados; zero correspondeu a ligamento não identificado, e 5 a ligamento visualizado integralmente. Foi considerado nível de significância de 5%. Para cada par de medidas obtidas, construíram-se dispersões e parcelas de Bland-Altman. Resultados: Todos os ligamentos foram identificados pelos examinadores de ultrassonografia, recebendo pontuação 4 ou 5, em relação à sua visibilidade, e foram identificados pelos examinadores de ressonância magnética, com pontuação 5. Foram considerados intactos e saudáveis pelos quatro examinadores. As comparações entre ultrassonografia e ressonância magnética na avaliação dos ligamentos do cotovelo não demostraram diferenças significativas. Conclusão: Quando realizada por examinadores experientes, a ultrassonografia pode ser considerada semelhante à ressonância magnética na avaliação de ligamentos do cotovelo.
Subject(s)
Humans , Magnetic Resonance Imaging/methods , Ultrasonography/methods , Elbow Joint/diagnostic imaging , Ligaments, Articular/diagnostic imaging , Reference Values , Prospective Studies , Reproducibility of Results , Elbow Joint/anatomy & histology , Ligaments, Articular/anatomy & histologyABSTRACT
Background The situation of zonule is very important for determining the cataract surgery.Ultrasound biomicroscopy (UBM) is an important method to observe the situation of zonule before cataract surgery.Objective This study was to evaluate the accuracy and clinical significance of observing the zonule of cataract patients by UBM.Methods A series cases-observational study was performed.One hundred and thirty eyes of 130 cataract patients who were to receive extracapsular cataract enucleation were enrolled in Tianjin Eye Hospital from January to June 2015,including 59 eyes with cataract associated with primary angle-closure glaucoma (PACG) and 71 eyes with traumatic cataract.UBM examination was carried out before surgery,and the abnormalities of zonule were recorded and compared between UBM and surgery findings.This study was approved by the Ethic Committee of Tianjin Eye Hospital and informed consent was obtained from all subjects.Results A large space between lens and cilliary was exhibited and the echo of zonule was clear on the UBM image in the eyes with traumatic cataract.The typical anatomic findings of the anterior eye segment were displayed,and lens equator came into contact with cilliary on the UBM image,and the echo of zonule was blurry in the eyes with cataract associated with PACG.The eye number of abnormal zonule was consistent between UBM and surgery findings (Kappa=O.952),and no significant difference in the eye number of abnormal zonule between UBM and surgery findings (P =0.250).In 75 zonule abnormal eyes diagnosed by both UBM and surgery findings,zonule abnormal range could not be compared in 1 eye (1/130,0.77％),and exactly consistent in 8 eyes (8/130,6.15％) between the two methods.The difference of zonule abnormal range between the two methods was 1 clock in 35 eyes (35/130,26.92％),and 2 clock in 27 eyes (27/130,20.77％),3 clock in 4 eyes (4/130,3.08％).In 74 zonule abnormal eyes,the mean difference of zonule abnormal meridian between the two methods was (1.36 ± 1.29) clock,an those in 28 traumatic cataract eyes and 36 cataract with PACG eyes were (1.14±1.10) clock and (1.64-± 1.48) clock,respectively.Conclusions UBM is able to observe zonule accurately,the observation effectiveness of UBM for traumatic cataract is better than that of cataract combined with PACG.These results are of clinical valueable for surgical strategy of cataract and prediction of surgical complications.