目的：探讨超声在髋关节前上盂唇撕裂中的诊断价值。方法：连续收集102例临床拟诊髋关节盂唇撕裂患者的超声检查、磁共振检查（magnetic resonance imaging，MRI）和关节镜手术资料，其中男性42例，女性60例，平均年龄（35.14±9.16）岁（13~60岁）， 左侧髋关节44例，右侧髋关节58例。以关节镜手术为金标准，评估超声诊断髋关节前上盂唇撕裂的敏感性、特异性、阳性预测值、阴性预测值和准确性，并与MRI比较。结果：所有病例均经关节镜手术证实，其中91例为髋关节前上盂唇撕裂，11例髋关节盂唇无撕裂。超声正确诊断69例，包括髋关节前上盂唇撕裂60例和髋关节盂唇无撕裂9例；其余33例中，超声误诊2例，漏诊31例；超声评估髋关节前上盂唇撕裂的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为65.93%、81.82%、96.77%、22.50%和67.65%。MRI正确诊断77例，包括髋关节前上盂唇撕裂70例和髋关节盂唇无撕裂7例；其余的25例中，误诊4例，漏诊21例；MRI评估髋关节前上盂唇撕裂的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为76.92%、63.64%、94.59%、25.00%和75.49%。超声检查与MRI检查结果相比，在评估髋关节前上盂唇撕裂的准确性上，超声检查低于MRI，差异有统计学意义（P＜0.01）。结论：超声诊断髋关节前上盂唇撕裂的敏感性略低于MRI，但超声检查的特异性高，动态评估是超声检查的优势，可以作为一种有效的检查方法。
Objective： To explore the value of ultrasound in the diagnosis of anterosuperior acetabular labral tear. Methods: A total of 102 patients ［(42 males and 60 females, age from 13 to 60 years, average age was (35.14±9.16) years］ with suspected anterosuperior acetabular labral tear were included in this study, including 44 left hip joints and 58 right hip joints. All the patients received hip joint ultrasound and magnetic resonance imaging (MRI) evaluation before arthroscopy surgery. Using arthroscopy as golden standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy between ultrasound and MRI were calculated and compared. Results: There were 91 antero-superior acetabular labral tears of 102 patients which were confirmed during arthroscopy surgery. Sixty-nine patients were diagnosed correctly by ultrasound, including 60 anterosuperior acetabular labral tears and 9 with no acetabular labral tears, whereas 2 were false-positive and 31 were found to be false-negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy by ultrasound were respectively 65.93%, 81.82%, 96.77%, 22.50% and 67.65%. In contrast, seventy-seven patients were diagnosed correctly by MRI, including 70 anterosuperior acetabular labral tears and 7 with no acetabular labral tears, whereas 4 were false-positive and 21 were found to be falsenegative. For MRI, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were respectively 76.92%, 63.64%, 94.59%, 25.00% and 75.49%. The results of ultrasound and MRI were in accordance in 68 of the 102 patients. There were 51 anterosuperior acetabular labral tears of the 68 patients who were diagnosed by both ultrasound and MRI, whereas there were 17 with no acetabular labral tears of the 68 patients who were diagnosed by both ultrasound and MRI. The results of ultrasound and MRI were inconsistent in 34 of the 102 patients. In 11 of the 34 patients, in which case ultrasound diagnosed anterosuperior acetabular labral tear, MRI found no acetabular labral tear. Whereas, in 23 of the 34 patients, in which case MRI diagnosed anterosuperior acetabular labral tear, ultrasound found no acetabular labral tear. As compared with MRI findings, ultrasound had a lower accuracy for anterosuperior acetabular labral tear than MRI, there was statistical difference on the accuracy for anterosuperior acetabular labral tear (P<0.01). Conclusion: Although ultrasound had a slightly lower sensitivity for anterosuperior acetabular labral tear, it had a higher specificity than MRI. Dynamic evaluation of anterosuperior acetabular labral tear is an advantage of ultrasound. Ultrasound could be used as a feasible me-thod to evaluate anterosuperior acetabular labral tear.
