MRI联合肌骨高频超声在小腿肌腱损伤诊断中的应用价值  

The Application Value of MRI Combined with High Frequency Musculoskeletal Ultrasound in the Diagnosis of Calf Tendon Injury

作　　者：刘立陶 徐亚莉 韩广香 杨帆[1] 王茵 LIU Litao;XU Yali;HAN Guangxiang;YANG Fan;WANG Yin(Langfang City People’s Hospital,Hebei 065000,China)

机构地区：[1]廊坊市人民医院,河北065000

出　　处：《影像科学与光化学》2025年第2期60-65,共6页Imaging Science and Photochemistry

基　　金：2023年廊坊市科学技术研究与发展计划自筹经费项目(2023013145)。

摘　　要：目的:评估磁共振成像(MRI)结合肌骨高频超声对小腿肌腱损伤诊断效果,并总结其影像学特征,以期为临床提供新的诊断思路。方法:选取2021年6月至2023年12月在本院收治的49例小腿肌腱损伤患者临床及影像学资料,由两位具有10年以上经验的放射科医师采用双盲法,独立进行高频超声和MRI诊断。通过比较患者患侧及健侧肌腱的高频超声和MRI表现,结合临床诊断结果,采用串联试验法和受试者操作特征(ROC)曲线评估两种影像学方法的联合诊断效果。结果:经关节镜检查、手术和随访确认,49例患者中,37例(75.51%)为跟腱损伤,12例(24.48%)为跖肌腱损伤。MRI显示,1~2级脂肪浸润患者占85.71%,而3~4级仅占8.16%。高频超声检查中,患侧肌腱平均灰度值比健侧平均灰度值低[(33.96±9.31)vs.(67.71±10.09)](P<0.001),肌腱血流信号以1级(57.14%)最为常见。高频超声联合MRI的诊断AUC值为0.957,灵敏度为93.8%,特异度为70.0%,均优于单独使用高频超声(AUC=0.865)或MRI(AUC=0.798)。结论:MRI与肌骨高频超声的联合使用在诊断小腿肌腱损伤中显示出更高的准确性和可靠性,可为早期诊断提供有力的影像学支持。Objective:To evaluate the effect of magnetic resonance imaging(MRI)combined with musculoskeletal high⁃frequency ultrasound in the diagnosis of calf tendon injuries,and summarize their imaging characteristics,in order to provide new diagnostic ideas for clinical practice.Methods:The clinical and imaging data of 49 patients with calf tendon injury admitted to our hospital from June 2021 to December 2023 were selected.High⁃frequency ultrasound and MRI were independently performed by two radiologists with more than 10 years of experience in a double⁃blind method.By comparing the patients suffering from side and healthy side of high⁃frequency ultrasound and MRI manifestation of tendon,combined with the clinical diagnosis,using serial test and receiver operating characteristic(ROC)curve evaluation method and two kinds of imaging methods of diagnosis effect.Results:Among the 49 patients,37(75.51%)had achilles tendon injuries and 12(24.48%)had plantaris tendon injuries confirmed by arthroscopy,operation and follow⁃up.MRI showed that 85.71%of the patients had grade 1⁃2 fatty infiltration,while only 8.16%had grade 3⁃4 fatty infiltration.In high⁃frequency ultrasound examination,the average gray value of the tendon on the affected side was lower than that on the healthy side[(33.96±9.31)vs.(67.71±10.09)](P<0.001),and the most common blood flow signal of the tendon was grade 1(57.14%).The AUC value of high⁃frequency ultrasound combined with MRI was 0.957,the sensitivity was 93.8%,and the specificity was 70.0%,which were better than those of high⁃frequency ultrasound(AUC=0.865)or MRI(AUC=0.798)alone.Conclusion:The combination of MRI and high⁃frequency musculoskeletal ultrasound shows higher accuracy and reliability in the diagnosis of calf tendon injuries,which can provide strong imaging support for early diagnosis.

关 键 词：磁共振成像 肌骨 高频超声 小腿 肌腱损伤 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]