二维超声联合弹性成像诊断足底筋膜炎的临床价值  

Clinical value of two-dimensional ultrasound combined with elastography in the diagnosis of plantar fasciitis

作　　者：李丹平 赵云[2] 任亮 马文娟[4] 胡兵[1] LI Danping;ZHAO Yun;REN Liang;MA Wenjuan;HU Bing(Department of Ultrasound Imaging,Renhe Hospital Affiliated to China Three Gorges University,Yichang 443001,China;School of Medicine,China Three Gorges University,Yichang 443002,China;Department of Ultrasound Medicine,Yiling Hospital of Yichang,Yichang 443100,China;Tianjin Medical University,Tianjin 300203,China)

机构地区：[1]三峡大学附属仁和医院超声影像科,湖北宜昌443001 [2]三峡大学医学院,湖北宜昌443002 [3]宜昌市夷陵医院超声医学科,湖北宜昌443100 [4]天津医科大学,天津300203

出　　处：《临床超声医学杂志》2025年第4期296-300,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(82072004)。

摘　　要：目的探讨二维超声、应变式弹性成像(SE)、剪切波弹性成像(SWE)联合应用诊断足底筋膜炎(PF)的临床价值。方法选取经临床确诊的PF患者140例(病例组)和健康志愿者200例(对照组),所有受试者均接受二维超声、SE及SWE检查,比较两组足底筋膜厚度、应变比及剪切波速度的差异。绘制受试者工作特征(ROC)曲线分析各参数单独及联合应用对PF的诊断效能。结果病例组与对照组足底筋膜厚度、应变比、剪切波速度比较差异均有统计学意义(均P<0.001)。ROC曲线分析显示,足底筋膜厚度、应变比、剪切波速度诊断PF的曲线下面积分别为0.975、0.889、0.981,截断值分别为3.95 mm、0.75、3.75 m/s,灵敏度分别为87.1%、89.3%、99.3%,特异度分别为94.5%、77.0%、88.5%;三者联合应用诊断PF的曲线下面积为0.993,高于各参数单独应用,差异均有统计学意义(均P<0.05)。结论PF患者的足底筋膜厚度增加、硬度降低,二维超声、SE、SWE联合应用可提高对PF的诊断效能,有一定的临床价值。Objective To investigate the clinical value of the combined application of two-dimensional ultrasound,strain elastography(SE)and shear wave elastography(SWE)in the diagnosis of plantar fasciitis(PF).Methods A total of 140 clinically diagnosed PF patients(case group)and 200 healthy volunteers(control group)were selected.All subjects underwent two-dimensional ultrasound,SE and SWE,the differences of plantar fascia thickness,strain ratio and shear wave velocity between the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of each parameter alone and in combination for PF.Results There were significant differences in plantar fascia thickness,strain ratio and shear wave velocity between the case group and the control group(all P<0.001).ROC curve analysis showed that the area under the curve of plantar fascia thickness,strain ratio and shear wave velocity in the diagnosis of PF were 0.975,0.889 and 0.981,respectively,and cut-off values were 3.95 mm,0.75 and 3.75 m/s,the sensitivities were 87.1%,89.3%and 99.3%,and the specificities were 94.5%,77.0%and 88.5%,respectively.The area under the curve of the combination of the three parameters in the diagnosis of PF was 0.993,which was higher than that of each parameter alone,the differences were statistically significant(all P<0.05).Conclusion The thickness of plantar fascia increased and the hardness decreased in PF patients,and the combined application of two-dimensional ultrasound,SE and SWE can improve the diagnostic efficiency of PF,which has a certain clinical value.

关 键 词：超声检查 剪切波弹性成像 足底筋膜炎 联合诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]