Evaluation of Contrast Extravasation as a Diagnostic Criterion in the Evaluation of Arthroscopically Proven HAGL/pHAGL Lesions
Evaluation of Contrast Extravasation as a Diagnostic Criterion in the Evaluation of Arthroscopically Proven HAGL/pHAGL Lesions
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DOI：
10.1155/2014/283575
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发表时间：
2014-01-01
影响因子：
2.7
通讯作者：
Adam, Richard
中科院分区：
文献类型：
--
作者：
Maldjian, Catherine;Khanna, Vineet;Adam, Richard
目的。术前 MRI 诊断 HAGL 病变的有效性存在争议。关于 MRI 的实用性，各种调查得出了不同的结果。本研究的目的是应用一种通过观察造影剂外渗来诊断 HAGL/pHAGL 病变的新方法，并评估这种造影剂外渗到关节外间隙作为 HAGL/pHAGL 病变标志的可靠性。方法。我们利用特定标准来定义造影剂外渗。我们在 12 名经关节镜证实有 HAGL/pHAGL 病变的患者中评估了这些标准。我们还在对照组中评估了这些标准。结果。超过 83% 的关节镜阳性病例发生造影剂外渗。对比剂外渗作为评估 HAGL/pHAGL 病变的诊断标准表现出观察者间的高度一致性。结论。总之，如果维持严格的标准以确保造影剂位于关节外位置，则关节外造影剂外渗可以作为 HAGL 和 pHAGL 病变的有效且可靠的标志。在不存在外渗的情况下，“J”征虽然非特异性，但可能是细微 HAGL 和 pHAGL 病变的唯一证据。证据水平。 IV 级，回顾性病例对照系列。
Purpose. The validity of preoperative MRI in diagnosing HAGL lesions is debated. Various investigations have produced mixed results with regard to the utility of MRI. The purpose of this investigation is to apply a novel method of diagnosing HAGL/pHAGL lesions by looking at contrast extravasation and to evaluate the reliability of such extravasation of contrast into an extra-articular space as a sign of HAGL/pHAGL lesion. Methods. We utilized specific criteria to define contrast extravasation. We evaluated these criteria in 12 patients with arthroscopically proven HAGL/pHAGL lesion. We also evaluated these criteria in a control group. Results. Contrast extravasation occurred in over 83% of arthroscopically positive cases. Contrast extravasation as a diagnostic criterion in the evaluation of HAGL/pHAGL lesions demonstrated a high interobserver degree of agreement. Conclusions. In conclusion, extra-articular contrast extravasation may serve as a valid and reliable sign of HAGL and pHAGL lesions, provided stringent criteria are maintained to assure that the contrast lies in an extra-articular location. In cases where extravasation is not present, the "J" sign, though nonspecific, may be the only evidence of subtle HAGL and pHAGL lesions. Level of Evidence. Level IV, Retrospective Case Control series.