高频超声联合超微血流成像对肱三头肌肌腱断裂伴骨化性肌炎的诊断价值

doi:10.3969/j.issn.1000-8535.2023.11.004

摘要/Abstract

摘要： 目的探讨与分析高频超声联合超微血流成像对肱三头肌肌腱断裂伴骨化性肌炎的诊断价值。方法选择2020年7月—2022年5月在本院诊治的84例肱三头肌肌腱断裂患者作为研究对象,所有患者均行关节镜及超声检查,超声检查包括高频超声、超微血流成像,记录超声特征并判断诊断价值,根据关节镜检查结果分为骨化性肌炎组和非骨化性肌炎组。结果 84例患者中,经关节镜检查判断为合并骨化性肌炎24例（骨化性肌炎组）,占比28.6%。骨化性肌炎组超声表现为肱三头肌肌腱纤维呈连续性中断,含稍强回声的非均质等回声,近侧断端肌腱有回缩并增厚。非骨化性肌炎组（60例）超声表现为肱三头肌肌腱纤维呈连续性中断,局限性边界清晰非均质性稍低回声,两断端中间呈不均质低回声。骨化性肌炎组的骨质破坏、软组织肿胀与关节积液等占比分别为75.0%、79.2%、79.2%,均高于非骨化性肌炎组的20.0%、25.0%、35.0%（P<0.05）。骨化性肌炎组的肌腱面积、肌腱厚度、血管条数均比非骨化性肌炎组更高（P<0.05）。84例患者中,高频超声、超微血流成像与两者联合诊断为肱三头肌肌腱断裂伴骨化性肌炎分别为18例、23例、24例,高频超声、超微血流成像与两者联合诊断肱三头肌肌腱断裂伴骨化性肌炎的灵敏度为70.8%（17/24）、91.7%（22/24）、100.0%（24/24）,特异度为98.3%（59/60）、98.3%（59/60）、100.0%（60/60）。结论肱三头肌肌腱断裂伴骨化性肌炎比较常见,高频超声联合超微血流成像在肱三头肌肌腱断裂伴骨化性肌炎的应用可有效反映病灶形态特征与血流特征,在诊断上具有很高的灵敏度与特异度。

关键词: 肱三头肌肌腱断裂, 骨化性肌炎, 高频超声, 超微血流成像, 血流特征, 诊断价值

Abstract: Objective To explore and analyze the diagnostic values of high-frequency ultrasound combined with superb microvascular imaging（SMI）in triceps brachii tendon rupture with ossifying myositis．Methods From July 2020 to May 2022,84 cases of patients with triceps brachii tendon rupture who were diagnosed and treated in our hospital were selected as research subjects．All patients underwent arthroscopy and ultrasonography,ultrasonography including high-frequency ultrasound and SMI,to record ultrasound characteristics and determine diagnostic value,and patients were divided into ossifying myositis group and non-ossifying myositis group according to the results of the arthroscopic examination．Results In 84 patients,there were 24 patients（28.6%）diagnosed as ossifying myositis by arthroscopy（ossifying myositis group）．The ultrasound findings of the ossifying myositis group were interruption of the triceps brachii muscle tendon fibers with slightly strong echogenicity and heterogeneous isoechogenicity．The proximal severed tendon had retraction and thickening．In the non-ossifying myositis group（n=60）,the ultrasound findings showed a interruption of the triceps brachii muscle tendon fibers,with clear localized boundaries and slightly heterogeneous hypoechogenicity,and there was an uneven hypoechogenicity between the two broken ends．The proportions of bone destruction,soft tissue swelling and joint effusion in the myositis group were 75.0%,79.2% and 79.2%,which were significantly increased compared to 20.0%,25.0% and 35.0% in the non-ossifying myositis group（P<0.05）．The tendon area,tendon thickness and vascular number in the ossifying myositis group were significantly higher than those in the non-ossifying myositis group（P<0.05）．In the 84 patients,there were 18 cases,23 cases and 24 cases diagnosed of triceps tendon rupture with ossifying myositis by high-frequency ultrasound,SMI and their combination．The sensitivity of high-frequency ultrasound,SMI and their combination in the diagnosis of triceps tendon rupture with ossifying myositis were 70.8%（17/24）,91.7%（22/24） and 100.0%（24/24）,with specificity of 98.3%（59/60）,98.3%（59/60） and 100.0%（60/60）．Conclusions Triceps brachii tendon rupture with ossifying myositis is relatively common．The application of high-frequency ultrasound combined with SMI in triceps brachii tendon rupture with ossifying myositis can effectively reflect the morphological and blood flow characteristics of the lesion,with high sensitivity and specificity in diagnosis．

Key words: triceps brachii tendon rupture, ossifying myositis, high frequency ultrasound, ultramicro blood flow imaging, blood flow characteristics, diagnostic value

梁秋染. 高频超声联合超微血流成像对肱三头肌肌腱断裂伴骨化性肌炎的诊断价值[J]. 广州医药, 2023, 54(11): 24-29.

LIANG Qiuran. Diagnostic value of high-frequency ultrasound combined with superb microvascular imaging in triceps brachii tendon rupture with ossifying myositis[J]. Guangzhou Medical Journal, 2023, 54(11): 24-29.

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