| Objective:To explore anatomical structure of the posterolateral corner of the knee ligament with ultrasound techniques.Analyzing ultrasonic examination in the diagnosis ofthe posterolateral corner of the knee ligament injury clinical value.Materials and methods:In order to achieve goals,we use high-frequency ultrasound to scan 16 normal volunteers and 11 patients with posterior lateral ligament injury of the knee joint.During this process,we observe the lateral collateral ligament,popliteal tendon and popliteal ligament,in which case we summarize the anatomic of normal PLC structure,the techniques of ultrasonic scanning and the characteristics of sonographic.By comparing with the magnetic resonance images,wetry to evaluate the clinical value of ultrasonography in diagnosing PLC injury.Results:In order to more easily shows the lateral collateral ligament,popliteal tendon,popliteofibular ligamentin ultrasound,we choose the anatomical structure of lateral femoral condyle,fibular head and fibular styloid process as symbols and use the prone position for quick and clear images of the important ligament of posterolateral corner of the knee(PLC).Normal popliteus and popliteofibular ligament show low echo in ultrasonic images while the lateral ligament has high echo.The long and thick diameters of the right and left side lateral collateral ligament are(5.741 ± 0.521)cm vs(5.765 ± 0.486)cm and(0.246 ±0.036)cm vs(0.254 ± 0.049)cm;the right and left popliteal tendon are(2.439 ± 0.231)cm vs(2.494 ± 0.293)cm and(0.294 ± 0.059)cm vs(0.289 ±0.041)cm;the right and left popliteal ligament are(1.143 ± 0.261)cm vs(1.136 ± 0.230)cm and(0.238 ± 0.045)cm vs(0.244 ± 0.039)cm.In the control group,there was no statistical significance(About LCL length to diameter compared t = 0.284,p> 0.05,about LCL thick diameter compared t = 0.950,p> 0.05;About PT length to diameter compared t = 1.490,p > 0.05,about PT thick diameter compared t =-0.498,p> 0.05;About PFL length to diameter compared t =-0.095,p> 0.05,about PFL thick diameter compared t = 0.496,p > 0.05)in long diameters of the left and right ligament,meanwhile,there was also no statistical significance in thick diameters of the left and right ligament.In the control group,32 cases showed a positive correlation between the body mass index,body surface area and the long and thick diameters of LCL,PT,PFL(LCL length to diameter is associated with body surface area,BMI,r were 0.724,0.500,p< 0.05,LCL is associated with body surface area,BMI,thick diameter r were 0.565,0.597,p< 0.05;PT length to diameter is associated with body surface area,BMI,r were 0.750,0.654,p< 0.05,PT is associated with body surface area,BMI,thick diameter r were 0.618,0.550,p< 0.05;PFL length to diameter is associated with body surface area,BMI,r were 0.554,0.701,p < 0.05,the PFL is associated with body surface area,BMI,thick diameter r were 0.622,0.601,p< 0.05).There was statistical significance in the long and thick diameters between the experimental group and the control group(LCL length to diameter,thick diameter experimental group compared with control group a t value were 4.075,5.048,p < 0.05;PT length to diameter,thick diameter experimental group compared with control group a t value were 3.908,5.026,p< 0.05;PFL length to diameter,thick diameter experimental group compared with control group a t value were 6.271,4.096,p< 0.05).The ultrasound images of PLC injury presented as the reduction of ligament echo,the continuity and discontinuity of ligament echo,and the irregular low or no echo area around the ligament.19 cases of PLC ligament injury(including lateral collateral ligament injury,popliteal tendon trauma,popliteal ligament injury),5 cases of partial laceration injury of ligament and 3 cases of complete laceration injury of ligament were diagnosed by ultrasonic.Also to clinical surgery or MRIconfirmed ligament damage rate,ultrasound has the positive rate in the diagnosis of PLC injury.Conclusion:High frequency ultrasound can clearly show the important PLC ligament contorts and morphological structure.Prone position scanning method is more conveniently show PLC than supine position,and prone position scanning method is suitable for comparative evaluation of both sides especially.In the control group,there was no statistical significance(p >0.05)in long diameters of the left and right ligament,meanwhile,there was also no statistical significance(p >0.05)in thick diameters of the left and right ligament.In the experimental group,there was a positive correlation between the body mass index,body surface area and the long and thick diameters of LCL,PT,PFL.There was statistical significance in the long and thick diameters between the patients and the normal volunteers.Therefore,ultrasound is a convenient and reliable examination method in the diagnosis of PLC injury. |
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