肌骨高频超声在肘关节软组织损伤诊断中的应用价值  

Application value of musculoskeletal high-frequency ultrasound in the diagnosis of elbow joint soft tissue injury

作　　者：刘丽清 杨菲 路鑫铭 赵紫钰 Liqing Liu;Fei Yang;Xinming Lu;Ziyu Zhao(Department of Ultrasound Medicine,Xingtai General Hospital,North China Medical and Health Group,Xingtai 054000,China;Department of Ultrasound Medicine,Xingtai People's Hospital,Xingtai 054000,China)

机构地区：[1]华北医疗健康集团邢台总医院超声医学科,054000 [2]邢台市人民医院超声科,054000

出　　处：《中华肩肘外科电子杂志》2023年第1期24-29,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：邢台市市级科技计划自筹经费项目(2021ZC074)。

摘　　要：目的探讨肌骨高频超声在肘关节软组织损伤诊断中的应用价值。方法选择2020年1月至2022年1月本院收治的肘关节外伤患者120例作为研究对象,对所有患者行肘关节肌骨超声探查。分析肌骨超声对肘关节软组织损伤的检出情况。以MRI、超声随访、临床症状缓解、手术结果等作为诊断金标准。计算肌骨超声诊断肘关节软组织损伤的敏感性、特异性及准确性,并使用Kappa检验分析肌骨超声诊断结果与金标准检查结果之间的一致性。选用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析肌骨超声对肘关节软组织损伤的诊断效能。结果120例受检者中,金标准检查结果为肘关节软组织损伤患者共110例(91.67%),共明确诊断169处肘关节软组织损伤。肘关节软组织损伤类型以肌腱损伤[30.77%(52/169)]、韧带损伤[26.04%(44/169)]和骺软骨损伤[18.34%(31/169)]多见。在不同年龄段(3~14岁、>14岁)肘关节软组织损伤类型分布中,骺软骨损伤主要见于3~14岁儿童,3~14岁儿童骺软骨损伤发生率为37.50%(27/72),>14岁儿童骺软骨损伤发生率为8.33%(4/48),差异有统计学意义(x^(2)=12.787,P<0.05)。其余软组织损伤类型两个年龄段均有分布,差异无统计学意义(P>0.05)。肌骨超声诊断肘关节软组织损伤的敏感性为91.12%(154/169),特异性为90.00%(9/10),准确性为91.06%(163/179);Kappa检验结果显示,肌骨超声诊断肘关节周围软组织损伤的结果与金标准检查结果的一致性较好(Kappa值=0.489);ROC曲线分析显示,对应的曲线下面积(area under curve,AUC)为0.906,表明肌骨超声对肘关节周围软组织损伤具有较高的诊断价值。结论肌骨超声诊断肘关节软组织损伤的敏感性与特异性高,且具有较高的准确性,可有效减少漏诊及误诊的发生,能更好地满足临床诊断需求。Background The elbow joint is essential in the human body,composed of the distal end of the humerus and the proximal end of the radius and ulna.The anatomy of this joint is complex,and it is prone to soft tissue injuries due to trauma.Children are a high-risk group for soft tissue injuries of the elbow joint.Due to their young age,immature physical development,and tendency to play and engage in activities such as climbing and running,children are more likely to experience soft tissue injuries of the elbow joint.Additionally,because children cannot clearly express their feelings of illness due to age,diagnosing these injuries can be more complex,and medical imaging techniques are often needed for accurate diagnosis.CT and MRI scans are commonly used for soft tissue injuries of the elbow joint,but CT scans have high radiation doses,and MRI scans have long scan times and high costs,so they are generally not used as routine screening methods.In recent years,with the continuous development of ultrasound imaging technology,musculoskeletal ultrasound has gradually been applied in diagnosing and treating various joint fractures and soft tissue injuries due to its convenience,precise imaging,and lack of radiation.Objective To investigate the application value of musculoskeletal high-frequency ultrasound in diagnosing elbow joint soft tissue injury.Methods One hundred twenty patients with elbow joint trauma admitted to our hospital from January 2020 to January 2022 were selected as the research objects.All patients underwent musculoskeletal ultrasound exploration of the elbow joint.The detection of soft tissue injury of the elbow joint by musculoskeletal ultrasound was analyzed.MRI,ultrasound follow-up,remission of clinical symptoms,and surgical results were used as the gold diagnostic criteria.The sensitivity,specificity,and accuracy of musculoskeletal ultrasonography in diagnosing elbow joint soft tissue injury were calculated,and the Kappa test was used to analyze the consistency between musculoskeletal ultrasonography

关 键 词：肌骨超声 肘关节 隐匿骨折 软组织损伤 诊断价值 

分 类 号：R684[医药卫生—骨科学]