跟距骨桥的高频超声诊断价值  

The Value of High-frequency Ultrasonography in the Diagnosis of Talocalcaneal Bridge

作　　者：王洪军[1] 宋兵[1] 张晓红[1] 翟红燕 王少春[1] Wang Hongjun;Song Bing;Zhang Xiaohong;Zhai Hongyan;Wang Shaochun(Department of Ultrasound,Affiliated Hospital of Jining Medical College Jining,Shandong 272029,China)

机构地区：[1]济宁医学院附属医院超声医学科,山东省济宁市272029

出　　处：《中国超声医学杂志》2018年第10期935-938,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨高频超声对跟距骨桥的定位、定性、分型及其并发症的诊断价值。方法采用高频超声检测临床怀疑跟距骨桥的28例患者,共30足,所有患足行X线和CT对照检查,患者的主要临床症状为内踝肿物、内踝处疼痛或伴内外翻受限、足底麻木,其中22例22足选择手术治疗。结果以CT作为诊断跟距骨桥的金标准,超声诊断的准确度、灵敏度、特异度、阳性预测值、阴性预测值分别为:93.333%、94.737%、90.909%、94.737%、90.909%,Kappa值=0.856,两者具有较好的一致性。术中发现所有患者的并发症如胫神经卡压16例、骨桥表面滑膜囊肿11例、踇长屈肌腱受压移位1例,超声均能正确提示。CT仅提示11例骨桥表面滑膜囊肿,而其他并发症未能提示。X线则所有并发症均未提示。结论与X线和CT相比,高频超声可以明确定位和定性诊断跟距骨桥,并能准确提示胫神经卡压、新生滑膜囊肿、肌腱受压移位等并发症,具有非常重要的临床价值。Objective To evaluate the diagnostic value of high-frequency ultrasonography in locating, qualitative diagnosis, classification and complication of talocalcaneal bridge. Methods 28 patients with 30 feet were detected by High frequency ultrasonography. The patients, symptoms included internal malleolus swelling, pain, internal or external varus restriction and plantar numbness. High resolution CT were chosed as the gold standard. Finally, 22 patients with 22 feet underwent suigical treatment, surgical treatment of. Results The diagnostic accuracy, sensitivity, specificity, positive and negative predictive value were 93. 333%, 94. 737%, 90. 909%,94. 737%,90. 909%, respectively. Kappa value is 0. 856,and the two methods have good consistency. According to the result of surgery, all the complications were correctly diagnosed by ultrasound, including 16 cases of tibial nerve compression, 11 cases of synovial cyst of bone bridge surface and 1 case of flexor hallucis tendon displacement. While CT only showed 11 cases of bone bridge surface synovial cyst. The no complications were found in X-ray examination. Conclusions Compared with X-ray and CT, high-frequency ultrasound can give an accurate diagnosis of talocalcaneal bridge, and can indicate the tibial nerve entrapment, synovial cyst, tendon displacement and other complications, which has a very important value for clinical diagnosis and treatmente.

关 键 词：高频超声 跟距骨桥 跟距骨联合 距下关节 踝管综合征 胫神经 

分 类 号：R445.1[医药卫生—影像医学与核医学]