非止点性跟腱病患者的肌骨超声显像特征  

Musculoskeletal ultrasonographic features of noninsertional Achilles tendinopathy

作　　者：杨逸明 贺立娟[2] 王宝剑 王伟 张伟 张晓亮 常青 陈月峰 潘旭月 马玉峰 YANG Yiming;HE Lijuan;WANG Baojian;WANG Wei;ZHANG Wei;ZHANG Xiaoliang;CHANG Qing;CHEN Yuefeng;PAN Xuyue;MA Yufeng(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Department of Rehabilitation,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Department of Muscle Injury(Pain),Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Traumatology&Orthopedics Center,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Department of Ultrasound,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Department of Foot and Ankle,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]北京中医药大学东方医院康复科,北京100029 [3]北京中医药大学第三附属医院筋伤(疼痛)科,北京100029 [4]北京中医药大学第三附属医院骨伤中心,北京100029 [5]北京中医药大学第三附属医院超声科,北京100029 [6]北京中医药大学第三附属医院手足外科,北京100029

出　　处：《分子影像学杂志》2022年第6期804-809,共6页Journal of Molecular Imaging

基　　金：首都卫生发展科研专项项目(首发2020-2-7036)。

摘　　要：目的分析非止点性跟腱病患者肌骨超声显像特征。方法收集2020年11月~2022年4月共60例患者82足跟腱超声结果,将其分为健康对照组(A组,15例30足)和非止点性跟腱病组(B组,45例52足),应用肌骨超声和彩色多普勒血流显像观察并分析比较各组:(1)跟骨后结节上2 cm处跟腱厚度;(2)跟腱止点上2 cm处跟腱横截面积;(3)跟骨上缘上1 cm处Kager脂肪垫前后径;(4)跟骨后滑囊积液检出率;(5)跟腱内血流信号检出率。总结归纳非止点性跟腱病的超声显像特征。结果(1)跟骨后结节上2 cm处跟腱厚度:A组小于B组(0.43±0.06 cm vs 0.55±0.17 cm,P<0.05);(2)跟腱止点上2 cm处跟腱横截面积:A组小于B组(0.52±0.11 cm2 vs 0.74±0.23 cm2,P<0.05);(3)跟骨上缘上1 cm处Kager脂肪垫前后径:A组小于B组(1.01±0.21 cm vs 1.49±0.26 cm,P<0.05);(4)跟骨后滑囊积液检出率:A组未检出,B组38.46%,差异有统计学意义(P<0.05);(5)跟腱内血流信号检出率:A组未检出,B组51.92%,差异有统计学意义(P<0.05)。结论非止点性跟腱病超声显像特征为跟腱厚度增厚,跟腱横截面积增大,跟腱前Kager脂肪垫前后径增宽,跟骨后滑囊积液产生或增加,以及跟腱内部血管增生。Objective To summarize the musculoskeletal ultrasonographic features of noninsertional Achilles tendinopathy.Methods Ultrasound results of 82 Achilles tendons in 60 cases were collected from November 2020 to April 2022,and 15 cases including 30 feet were set as healthy control group(group A),45 cases including 52 feet as noninsertional Achilles tendon group(group B).Musculoskeletal ultrasound and color Doppler flow imaging were used to observe and compare the features of the noninsertional Achilles tendon:(1)The thickness of Achilles tendon at 2 cm above the posterior calcaneal tubercle;(2)The cross-sectional area of Achilles tendon at 2cm above the Achilles tendon insertion point;(3)The anterior-posterior diameter of Kager fat pad at 1cm above the upper edge of calcaneus;(4)The detection rate of retrocalcaneal bursal effusion;(5)The detection rate of blood flow signal in Achilles tendon.The features of noninsertional Achilles tendinopathy were summarized.Results(1)The thickness of Achilles tendon at 2 cm above the posterior calcaneal tubercle:group A was less than group B(0.43±0.06 cm vs 0.55±0.17 cm,P<0.05).(2)The cross-sectional area of Achilles tendon at 2 cm above the Achilles tendon insertion point:group A was less than group B(0.52±0.11 cm2 vs 0.74±0.23 cm2,P<0.05).(3)The anterior-posterior diameter of Kager fat pad at 1 cm above the upper edge of calcaneus:group A was smaller than group B(1.01±0.21 cm vs 1.49±0.26 cm,P<0.05).(4)The detection rate of retrocalcaneal bursal effusion:negative in group A and 38.46%in group B,the difference was statistically significant(P<0.05).(5)The detection rate of blood flow signal in Achilles tendon:group A was not detected and 51.92%in group B,the difference was statistically significant(P<0.05).Conclusion Noninsertional Achilles tendinopathy was characterized by thickening of Achilles tendon thickness,increasing of cross-sectional area of Achilles tendon,widening of anterior-posterior diameter of Kager fat pad,increasing of retrocalcaneal bursal effusion and the b

关 键 词：非止点性跟腱病 肌骨超声 成像特征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686.1[医药卫生—诊断学]