摘要: |
目的:探讨不同分型距腓前韧带损伤的超声表现及伤后健侧、病侧厚度的变化。方法:选取152例疑似单侧踝关节外侧副韧带损伤患者的临床资料进行回顾性分析,选取时间为2018年5月至2020年6月;以MRI检查结果为标准,即金标准确诊为距腓前韧带损伤(Ⅰ级47例、Ⅱ级24例、Ⅲ级11例)共82例;均予以超声检查,对比阳性预测值、阴性预测值;观察高频超声检查后的影像表现及距腓前韧带损伤不同分型的检出率;评估距腓前韧带损伤患者健侧与患侧距腓前韧带厚度;分析病侧韧带厚度与韧带损伤分型的相关性;评估超声诊断距腓前韧带损伤的AUC值、敏感度、特异度及约登指数。结果:152例疑似踝关节外侧副韧带损伤患者经高频超声检查后,阳性预测值为92.86%,阴性预测值为94.11%,与金标准相比,差异无统计学意义(P>0.05);且检出Ⅰ型损伤共42例、Ⅱ型损伤共25例、Ⅲ型损伤共11例,与金标准相比,差异无统计学意义(P>0.05)。Ⅰ型病侧韧带厚度为(2.54±0.81),Ⅱ型病侧韧带厚度为(2.89±1.02),Ⅲ型病侧韧带厚度为(3.11±1.09)mm。健侧韧带厚度为(2.01±0.41)mm,病侧韧带厚度为(2.72±0.93)mm,差异具有统计学意义(P<0.05)。Spearman相关性分析显示,病侧韧带厚度与韧带损伤分型呈正相关(r=0.314,P<0.05)。ROC曲线分析显示,超声诊断距腓前韧带损伤的AUC值为0.933,敏感度为95.10%,特异度为91.40%。结论:高频超声用于踝关节外侧副韧带损伤中具有较高的临床价值,且距腓前韧带损伤后韧带厚度较健侧增加明显,其厚度可随着距腓前韧带损伤分型的增加而随之上升。 |
关键词: 踝关节 距腓前韧带损伤 分型 高频超声 韧带厚度 |
DOI: |
投稿时间:2021-10-09修订日期:2022-06-05 |
基金项目: |
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Ultrasonic manifestations of different types of anterior talofibular ligament injuries and the thickness changes of the healthy side and the diseased side after injury |
zhangbaoling,lijie,jiangli |
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Abstract: |
Objective: To investigate the ultrasound findings of different types of anterior talofibular ligament injuries and the thickness changes of the healthy side and the diseased side after injury. Methods: The clinical data of 152 patients with suspected unilateral lateral ankle collateral ligament injury were selected for retrospective analysis, and the selection time was from May 2018 to June 2020; MRI examination results were used as the standard, that is, the gold standard diagnosis was diagnosed as anterior talofibular A total of 82 cases of ligament injury (47 cases of grade Ⅰ, 24 cases of grade Ⅱ, 11 cases of grade Ⅲ); all underwent ultrasound examination to compare the positive predictive value and negative predictive value; observe the imaging performance and anterior talofibular ligament after high-frequency ultrasound The detection rate of different types of injury; evaluate the thickness of the uninfected and affected anterior talofibular ligament in patients with anterior talofibular ligament injury; analyze the correlation between the thickness of the diseased side ligament and the type of ligament injury; evaluate the ultrasound diagnosis of anterior talofibular ligament injury AUC value, sensitivity, specificity and Youden index. Results: After high-frequency ultrasound examination of 152 patients with suspected lateral ankle collateral ligament injury, the positive predictive value was 92.86% and the negative predictive value was 94.11%. Compared with the gold standard, the difference was not statistically significant (P>0.05); In addition, 45 cases of type I injury were detected with a percentage of 29.61%, 22 cases of type II injury with a percentage of 14.47%, and 11 cases of type III injury with a percentage of 7.24%. Compared with the gold standard, the difference was not statistically significant ( P>0.05). The thickness of the contralateral ligament is (2.01±0.41) mm, and the thickness of the diseased side ligament is (2.72±0.93) mm; the thickness of the diseased side ligament is higher than that of the contralateral ligament, and the difference is statistically significant (P>0.05); Type I diseased side The thickness of the ligament is (2.54±0.81), the thickness of the type II side ligament is (2.89±1.02), and the thickness of the type III side ligament is (3.11±1.09) mm. Spearman correlation analysis showed that the thickness of the diseased side ligament was positively correlated with the type of ligament injury (r=0.314, P<0.05). ROC curve analysis showed that the AUC value of ultrasonic diagnosis of anterior talofibular ligament injury was 0.933, the sensitivity was 95.10%, and the specificity was 91.40%. Conclusion: High-frequency ultrasound has high clinical value in the injury of the lateral collateral ligament of the ankle, and the thickness of the ligament after the injury of the anterior talofibular ligament is significantly increased than that of the healthy side, and its thickness can increase with the classification of the anterior talofibular ligament injury. And then it rises. |
Key words: ankle joint anterior talofibular ligament injury classification high-frequency ultrasound ligament thickness |