多参数高频超声与MRI优化距腓前韧带损伤诊断的临床价值  

Clinical value of multiparametric high-frequency ultrasound and MRI in optimizing the diagnosis of anterior talofibular ligament injuries

作　　者：李玲[1] 肖莹莹 杨洁[2] 牛娟鹏 申英灏 吴杰燕[2] LI Ling;XIAO Yingying;YANG Jie;NIU Juanpeng;SHEN Yinghao;WU Jieyan(The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Ultrasound,Gansu Provincial People's Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃省人民医院超声医学科,甘肃兰州730000

出　　处：《分子影像学杂志》2025年第4期424-428,共5页Journal of Molecular Imaging

基　　金：甘肃省自然科学基金(24JRRA609,23JRRA1312)。

摘　　要：目的对比高频超声与MRI在距腓前韧带(ATFL)损伤诊断及慢性踝关节不稳(CAI)早期判断中的价值。方法选取2020年1月~2024年8月于甘肃省人民医院就诊的80例单侧踝关节受伤患者,均接受高频超声及MRI检查,并根据损伤程度进行分级,测量并比较患侧与健侧的ATFL厚度、长度,以及距腓关节间隙角度。以手术结果为金标准,绘制高频超声与MRI诊断ATFL损伤的ROC曲线,并计算其诊断效能。结果80例患者中,高频超声诊断出I级损伤13例,II级损伤39例,III级损伤28例;MRI诊断出I级损伤24例,II级损伤42例,III级损伤14例。高频超声对I级损伤的检出率低于MRI,II级损伤的检出率略低于MRI,而III级损伤的检出率高于MRI(P<0.001)。结论高频超声检查患侧ATFL厚度与损伤分型呈正相关,患侧ATFL的距离腓关节间隙角度及长度与CAI的诊断符合率呈正相关。结合多项超声参数进行CAI的诊断具有更高的临床价值,可为韧带损伤的手术修复提供客观依据。Objective To compare the value of high-frequency ultrasound and MRI in the diagnosis of anterior talofibular ligament(ATFL)injury and early detection of chronic ankle instability(CAI).Methods Eighty patients with unilateral ankle injuries who receive treatment at Gansu Provincial People's Hospital from January 2020 to August 2024 were selected.All patients underwent both high-frequency ultrasound and MRI,with injury severity classified into three grades.The thickness and length of the ATFL,as well as the angle of the talofibular joint space,were measured and compared between the healthy and affected sides.Surgical outcomes were used as the gold standard,and ROC curves for ATFL injury diagnosis by both high-frequency ultrasound and MRI were plotted to evaluate diagnostic efficacy.Results Among the 80 patients,high-frequency ultrasound detected 13 cases of grade I,39 cases of grade II,and 28 cases of grade III injuries,while MRI detected 24 cases of grade I,42 cases of grade II,and 14 cases of grade III.The detection rate of grade I injury by high-frequency ultrasound was significantly lower than MRI,with grade II detection slightly lower and grade III detection significantly higher than MRI(P<0.001).Conclusion The thickness of the affected ATFL was positively correlated with injury grade.The angle of the affected ATFL relative to the talofibular joint space and its length were positively correlated with the diagnostic concordance rate for chronic ankle instability.Combining multiple ultrasonographic parameters proved more valuable for diagnosing chronic ankle instability,providing an objective basis for surgical repair of ligament injuries.

关 键 词：高频超声 磁共振成像 距腓前韧带损伤 慢性踝关节不稳 手术结果 

分 类 号：R445.1[医药卫生—影像医学与核医学]