高频肌骨超声诊断踝关节外侧副韧带损伤的价值  

The value of high-frequency musculoskeletal ultrasound in diagnosing lateral collateral ligament injury of the ankle joint

作　　者：李娜娜 李金勇 张丽平 LI Nana;LI Jinyong;ZHANG Liping(Department of Ultrasound,Baofeng Branch of the Second People's Hospital of Pingdingshan,Pingdingshan,Henan 467400,China;Department of Ultrasound,Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou,Henan 466000,China;Department of Ultrasound,Beijing Jingbei Hospital,Beijing 100192,China)

机构地区：[1]平顶山市第二人民医院宝丰分院超声科,河南平顶山467400 [2]周口市中医院超声科,河南周口466000 [3]北京京北医院超声科,北京100192

出　　处：《社区医学杂志》2024年第15期513-518,共6页Journal Of Community Medicine

摘　　要：目的探讨高频肌骨超声技术在识别踝关节外侧副韧带损伤类型、损伤程度等方面的价值。方法选取2021-01-03-2023-01-03平顶山市第二人民医院踝关节外侧副韧带损伤患者90例作为研究对象。所有患者均进行高频肌骨超声检查,所有患者均进行磁共振成像(MRI)、术中探查、高频肌骨超声,并以MRI及术中探查为金标准,采用χ^(2)检验对比高频肌骨超声、MRI与术中探查可见损伤情况;采用Kappa检验对比高频肌骨超声检查与MRI与术中探查踝关节外侧副韧带损伤分级诊断结果的一致性情况;另外,治疗后预后评估金标准为美国足与踝协会(AOFAS)评分评估预后结果,采用χ^(2)检验对比分析踝关节外侧副韧带损伤评估预后中高频肌骨超声与AOFAS评分的情况。结果90例踝关节外侧副韧带损伤患者中,MRI及术中探查结果显示距腓后韧带损伤13例(14.44%),高频肌骨超声探查距腓后韧带损伤12例(13.33%),差异无统计学意义,χ^(2)=0.047,P=0.829;MRI及术中探查结果显示距腓前韧带伴跟腓韧带损伤16例(17.78%),高频肌骨超声探查距腓前韧带伴跟腓韧带损伤15例(16.67%),差异无统计学意义,χ^(2)=0.039,P=0.844;MRI及术中探查结果显示单纯跟腓韧带损伤20例(22.22%),高频肌骨超声探查单纯跟腓韧带损伤15例(21.11%),差异无统计学意义,χ^(2)=0.033,P=0.856;MRI及术中探查结果显示单纯距腓前韧带损伤42例(46.67%),高频肌骨超声探查距腓前韧带伴跟腓韧带损伤43例(47.78%),差异无统计学意义,χ^(2)=0.022,P=0.881;距腓前韧带伴跟腓韧带损伤15例,单纯跟腓韧带损伤19例,单纯距腓前韧带损伤43例;经MRI与术中探查显示90例踝关节外侧副韧带损伤者中,Ⅰ型18例,Ⅱ型52例,Ⅲ型20例。高频肌骨超声检查结果与金标准检查结果一致,Kappa值=0.825,P<0.001。经AOFAS评分评估预后结果90例踝关节外侧副韧带损伤患者中优50例(55.56%),高频肌骨超声评估预后结果�Objective To explore the value of high-frequency musculoskeletal ultrasound technology in identifying the type and degree of lateral collateral ligament injury in the ankle joint.Methods Totally 90 patients with lateral collateral ligament injury of the ankle joint during January 3,2021,to January 3,2023,in Second People's Hospital of Pingdingshan were selected as the research subjects.All patients underwent high-frequency musculoskeletal ultrasound examination,magnetic resonance imaging(MRI),intraoperative exploration.Using MRI and intraoperative exploration as the gold standard,theχ^(2)test was used to compare the visible injury conditions of high-frequency musculoskeletal ultrasound,MRI,and intraoperative exploration.The Kappa test was used to compare the consistency of the diagnostic results of high-frequency musculoskeletal ultrasound and MRI with intraoperative exploration for lateral ankle ligament injuries.In addition,the gold standard for prognosis evaluation after treatment is the American Association of Foot and Ankle(AOFAS)score to evaluate the prognosis results.Theχ^(2)test was used to compare the analysis of high-frequency musculoskeletal ultrasound and AOFAS scores in assessing the prognosis of lateral ankle ligament injuries.Results Among 90 patients with lateral collateral ligament injury of the ankle joint,MRI and intraoperative exploration results showed 13 cases(14.44%)of posterior talofibular ligament injury,and high-frequeicy musculoskeletal ultrasound detected 12 cases(13.33%),with no statistically significant difference(χ^(2)=0.047,P=P.829);MRI and intraoperative exploration results showed 16 cases(17.78%)of anterior talofibular ligament injury with calcaneofibular ligament injury,and high-frequency musculoskeletal ultrasound detected 15 cases(16,67%),with no statistically significant difference(χ^(2)=0.039,P=0.844);MRI and intraoperative exploration results showed 20 cases(22.22%)of simple injury to the calcaneal and fibular ligaments,and high-frequency musculoskeletal ultrasound dete

关 键 词：踝关节外侧副韧带损伤 高频肌骨超声 磁共振成像 单纯跟腓韧带损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学]