摘要
目的探讨高频超声对腕背部囊肿的诊断价值。方法回顾136例经手术及术后病理结果证实为腕背部囊肿的超声图像资料,分析其发生部位与声像图特征。结果高频超声诊断腕背部囊肿136例,根据发生解剖层次的不同可分为伸肌支持带囊肿、伸肌腱滑液鞘囊肿和骨间背侧韧带囊肿,所占百分比分别为1.5%(2/136)、24.3%(33/136)和74.2%(101/136)。囊肿具体发生部位排在前3位的是舟月背侧韧带、指伸肌腱及示指伸肌腱滑液鞘、桡侧腕长及腕短伸肌腱滑液鞘,所占百分比分别为60.3%(82/136)、8.1%(11/136)和6.6%(9/136)。腕背部囊肿具有典型的声像图表现:二维灰阶超声显示伸肌支持带囊肿体积较小,呈椭圆形无回声区,边界清晰,位于水肿增厚的伸肌支持带内,与伸肌腱无联系,多同时合并舟月背侧韧带囊肿;伸肌腱滑液鞘囊肿位于伸肌腱旁,呈椭圆形或茄形包绕肌腱,与骨间背侧韧带及伸肌支持带无联系,骨间背侧韧带呈正常的条索状回声,表面光滑、平整;骨间背侧韧带囊肿呈不规则形无回声区,位于受损韧带浅方,受损韧带增厚、回声减低,表面不光整,内部条索状回声连续性完全中断或部分中断致局部变细。彩色多普勒血流成像示腕背部囊肿内均无血流信号。结论高频超声能够对腕背部囊肿作出准确的定位诊断,可作为指导临床治疗首选的影像学检查方法。
Objective To evaluate the diagnostic value of high-frequency ultrasonography for dorsal wrist cyst.MethodsThe ultrasonographic characteristics of 136 dorsal wrist cysts were retrospectively studied and compared with the pathological results, the locations and the imaging characteristics of the cysts were analysed, hence to conclude the diagnostic value of high-frequency ultrasonography.ResultsBased on the anatomical location diagnosed by high frequency ultrasound, the 136 dorsal cysts were divided into three types： extensor retinaculum cysts, synovial tendon sheath cysts and dorsal interosseous ligament cysts, each accounted for 1.5% （2/136）, 24.3% （33/136） and 74.2% （101/136） of the study group. The most frequently detected locations for dorsal cysts were dorsal scapholunate ligament,tendinous sheath of extensor digitorum and extensor indicis, as well as tendinous sheath of extensor carpi radialis longus and brevis,each accounted for 60.3% （82/136）, 8.1% （11/136） and 6.6% （9/136） of all dorsal wrist cysts respectively. Dorsal wrist cysts had typical ultrasonographic features on 2-D gray-scale ultrasonography, the extensor retinaculum cyst demonstrated as a well-marginated, small-sized and oval anechoic area, which was commonly located in the oedematous extensor retinaculum, but it had no adjunction with the extensor tendon, and it was accompanied with dorsal scapholunate ligment cyst frequently. Synovial tendon sheath cyst demonstrated as a oval or eggplant-shaped anechoic area which was usually winding around the extensor tendon, but it had no adjunction with the dorsal interosseous ligament and the extensor retinaculum. Meanwhile, the dorsal interosseous ligament appeared to be normal strip-like echo texture with a smooth and clear margin. Dorsal interosseous ligament cyst demonstrated as a out-of-shape anechoic area and located superior to the injured ligament. Meanwhile, the impaired ligament was thickened with uneven margin and decreased echo texture. No blood lfow signals was detected in all dorsal wrist cysts by color doppler lfow imaging.ConclusionHigh-frequency ultrasonography can be used to diagnosis dorsal wrist cysts, and can be served as the preferred imaging modelity to guide the clinical treatment.
出处
《中华医学超声杂志（电子版）》
2014年第10期66-69,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
深圳市龙岗区“专家提升计划”攻关项目(ZJTS22009009)
关键词
超声检查
腕
韧带
囊肿
Ultrasonography
Wrist
Ligaments
Cysts
