高频超声及MRI在上肢肌腱损伤诊断及预后评估中的应用分析  

作　　者：范慧慧[1] 徐华军[1] 施林枫[1] 胡先芳[1] 张惠美[1] 

机构地区：[1]浙江省湖州市中心医院,313000

出　　处：《浙江临床医学》2022年第6期895-897,共3页Zhejiang Clinical Medical Journal

基　　金：湖州市公益性应用研究项目(2017GYB25,2018GYB68)。

摘　　要：目的探讨高频超声及磁共振成像(MRI)在上肢肌腱损伤诊断及预后评估中的应用价值。方法回顾性分析102例上肢肌腱损伤患者的临床资料以及高频超声、MRI影像学检查资料,以手术诊断结果为金标准,比较高频超声、MRI以及高频超声+MRI诊断不同上肢肌腱损伤程度的符合率,并分析手术前后上肢肌腱损伤高频超声、MRI影像学征象。结果手术诊断结果显示,102例上肢肌腱损伤患者中,33例完全断裂(32.35%)、38例部分断裂(37.25%)、31例慢性磨损(30.39%)。高频超声+MRI联合诊断符合率(96.08%)高于MRI(81.37%)及高频超声(77.45%)单一诊断,差异有统计学意义(P<0.05)。上肢肌腱损伤缝合术后1~2周,肌腱吻合口回声减少,边界模糊,内部出现斑片状强回声;术后3~4周,部分肌腱吻合口边界逐渐清晰,并出现纤维状强回声,左右吻合口回声接近正常肌腱,部分肌腱吻合口显著增厚,结构紊乱,与周边组织分界模糊;术后6周是肌腱-骨恢复的基线时间,与健侧肌腱比较,多数损伤肌腱出现增厚趋势。结论高频超声联合MRI应用于上肢肌腱损伤患者,能有效提高不同损伤程度诊断符合率,为临床辨别损伤类型、制定针对性治疗方案、判断预后提供影像学支持。Objective To explore the application value of high frequency ultrasound and magnetic resonance imaging(MRI)in the diagnosis and prognosis evaluation of upper limb tendon injuries.Methods The clinical data and the imaging data of high frequency ultrasound and MRI of 102 cases of upper limb tendon injury were analyzed retrospectively,and the surgical results were used as the gold standard.The coincidence rate of high frequency ultrasound,MRI and high frequency ultrasound+MRI in diagnosing different degree of upper limb tendon injury were compared,and the imaging signs of high frequency ultrasound and MRI before and after operation were analyzed.Results The results of surgical diagnosis showed that in 102 cases of upper limb tendon injury,33 cases were completely ruptured(32.35%),38 cases were partially ruptured(37.25%),and 31 cases were chronic wear(30.39%).The coincidence rate of high frequency ultrasound combined with MRI(96.08%)was higher than that of MRI(81.37%)and high frequency ultrasound(77.45%)single diagnosis(P<0.05).One to two weeks after the suture of upper limb tendon injury,the echo of tendon anastomotic stoma decreased,the boundary was fuzzy,and the patch hyperecho appeared inside;at 3~4 weeks after operation,the anastomotic boundary of some tendons became clear gradually,and fibrous hyperechogenicity appeared.The echo of the left and right anastomoses was close to that of the normal tendons,and the anastomotic boundary of some tendons was significantly thickened,disordered,and blurred with the surrounding tissues;the baseline time of tendon bone recovery was 6 weeks after operation.Compared with the contralateral tendon,most of the injured tendons tended to thicken.Conclusion High frequency ultrasound combined with MRI applied to patients with upper limb tendon injuries can effectively improve the diagnostic coincidence rate of different injury degrees,and provide imaging support for clinical identification of injury types,formulation of targeted treatment plans,and prognosis.

关 键 词：高频超声 磁共振成像 上肢肌腱损伤 预后 影像学征象 

分 类 号：R44[医药卫生—诊断学]