高频超声评估慢性踝关节不稳定的诊断价值  

Diagnostic value of high frequency ultrasound in chronic ankle instability

作　　者：陈征[1] 李建国[1] 田辉[1] 车东东[1] 朱家安[1] 

机构地区：[1]北京大学人民医院超声科,北京100044

出　　处：《肿瘤影像学》2015年第2期85-89,共5页Oncoradiology

摘　　要：目的:应用高频超声测量中立位和前抽屉应力位下距腓前韧带(ATFL)的长度变化,探讨应力位超声检查对慢性踝关节不稳定(CAI)的诊断价值。方法:将80例受检者(共134个踝关节)分为两组:无踝扭伤病史的健康对照组(共80个踝关节)和CAI患者组(共54个踝关节)。通过声像图测量ATFL在中立位和前抽屉应力位下的长度变化。受检者通过Cumberland踝关节不稳定评定问卷自我定量评估日常活动和体育运动中的踝关节功能,用前抽屉试验评定踝关节的松弛程度,统计两组间应力位超声检查结果差异有无统计学意义,并分析其与前抽屉试验的相关性。结果:健康对照组双侧ATFL长度变化差异无统计学意义。健康对照组与CAI患者组ATFL长度变化差异有显著统计学意义(P<0.001)。应力位超声检查结果与前抽屉试验呈显著正相关。结论:应力位超声检查与前抽屉试验具有良好的相关性,可定性和定量评估踝关节的松弛程度,并可作为踝关节陈旧扭伤所致慢性机械性不稳定的客观有效的诊断依据。Objective: To use high frequency ultrasonography to measure the changes in anterior talofibular ligament(ATFL) length in the neutral and anterior drawer stress positions and to discuss the value of stress ultrasonography in the diagnosis of chronic ankle instability(CAI). Methods: Eighty subjects(134 ankles) were divided into two groups: control subjects without ankle injury history(80 ankles) and subjects with CAI(54 ankles). The changes in ATFL length in the neutral and anterior drawer stress positions were measured from ultrasound images. The Cumberland ankle instability tool(CAIT) was used to quantify self-reported functional activities of daily living and sports. The manual anterior drawer test was performed to assess the ankle laxity. The statistical significance of stress ultrasonography between the two groups was analyzed and the relationship between stress ultrasonography and manual anterior drawer test was evaluated. Results: The changes in ATFL length between bilateral ankles in the control group were not significantly different. There was significant difference in the changes in ATFL length between the two groups(P<0.001). There was positive relationship between stress ultrasonography and manual anterior drawer test. Conclusion: Stress ultrasonography is positively correlated with manual anterior drawer test. It is valuable in the qualitative and quantitative evaluation of ankle laxity, and can be used as an objective and effective method in the diagnosis of mechanical CAI caused by old ankle sprain.

关 键 词：超声 慢性踝关节不稳定 踝扭伤 距腓前韧带 前抽屉试验 

分 类 号：R684[医药卫生—骨科学] R445.1[医药卫生—外科学]