髂腰肌囊扩张的超声和核磁共振对比观察  

Observation and comparison of high frequency ultrasonography and magnetic resonance imaging in enlarged iliopsoas bursa

作　　者：席贵阳 吴志华[1] 朱东升[1] 彭亮[1] 舒华宝 吴晓敏 吴红平 徐圣 Xi Guiyang;Wu Zhihua;Zhu Dongsheng;Peng Liang;Shu Huabao;Wu Xiaomin;Wu Hongping;Xu Sheng(Special Diagnostic Department, No.184 Hospital of PLA, Yingtan 335000, China)

机构地区：[1]解放军第一八四医院特诊科

出　　处：《海军医学杂志》2019年第4期327-329,343,共4页Journal of Navy Medicine

摘　　要：目的比较高频超声与核磁共振成像(MRI)在髂腰肌囊扩张诊断中的异同,探讨高频超声在髂腰肌囊扩张诊断中的应用价值.方法回顾性分析2008年7月至2018年1月于解放军第一八四医院经超声和MRI检查的208例髂腰肌囊扩张的疑似病例,与经临床及手术病理结果对照分析.结果髂腰肌囊扩张的主要超声影像学特征为髋关节囊前方和髂腰肌腱(腹)间大小不等、形态各异的单房或多房囊性包块,向上可达髂腰肌腹,向下可达小转子,包块增大时可压迫股静脉.超声对髂腰肌囊扩张诊断的灵敏度81.3%,特异度94.3%,阳性预测值72.2%,阴性预测值96.5%;MRI诊断的灵敏度90.6%,特异度97.7%,阳性预测值87.9%,阴性预测值98.3%,与MRI的Kappa值为0.82,2种方法灵敏度差异无统计学意义(P>0.05),特异度差异有统计学意义(P<0.01).结论 2种方法均可为髂腰肌囊扩张诊断提供有价值的影像学依据,高频超声完全可以作为临床诊断髂腰肌囊扩张的重要检查方法.Objective To compare the clinical significance of high frequency ultrasonography (HFU) versus magnetic resonance imaging (MRI) in the diagnosis of enlarged iliopsoas bursa, and also to explore the application value of HFU in the diagnosis of enlarged iliopsoas bursa.Methods A retrospective analysis was made on the 208 patients suspected of enlarged iliopsoas bursa by HFU or MRI, and the obtained results were compared and analyzed with those obtained from clinical and surgical pathological findings.Results The main ultrasonographic features of enlarged iliopsoas bursa were mono or multilocular cystic mass of different sizes and shapes in anterior capsule of the hip joint and between tendons (bellies) of the iliopsoas muscle, upward to the iliopsoas belly and downward to the lesser trochanter. The femoral vein could be pressed when the mass developed. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HFU for the diagnosis of enlarged iliopsoas bursa were respectively 81.3%, 94.3%, 72.2% and 96.5%, while the sensitivity, specificity, PPV and NPV of MRI were respectively 90.6%, 97.7%, 87.9% and 98.3%. The Kappa coefficient of MRI was 0.82. There was no statistical significance in sensitivity( P >0.05), when comparisons were made between the 2 detection methods. However, statistical significance could be noted in specificity( P <0.01), when comparisons were made between the 2 methods. Conclusion Both approaches could provide valuable imaging evidence for the diagnosis of enlarged iliopsoas bursa, and evidently HFU could be an important detection method for the diagnosis of enlarged iliopsoas bursa.

关 键 词：髂腰肌囊扩张 肌骨超声 核磁共振成像 比较影像学 

分 类 号：R693[医药卫生—泌尿科学] R455.1[医药卫生—外科学]