摘要
目的对比分析正常成人距腓前韧带(ATFL)中立位与跖屈内翻位超声弹性成像特征。方法选取21例志愿者,对其双侧ATFL行常规超声及剪切波弹性成像(SWE)检查,比较中立位与跖屈内翻位3个部位即ATFL中部、距腓骨附着处5 mm内及距距骨附着处5 mm内的剪切波速度(SWV)的差异。对SWE显示为无信号区域的ATFL行压迫式弹性成像检查,比较中立位与跖屈内翻位ATFL弹性应变率比值。采用组内相关系数(ICC)评估观察者间的可重复性。结果 42根ATFL在中立位均有信号填充;跖屈内翻位时,30根显示为硬度高的红色,12根无信号填充。中立位与跖屈内翻位ATFL中部、距腓骨附着处5 mm内及距距骨附着处5 mm内SWV比较[(2.2±0.5)m/s vs.(4.9±1.5)m/s、(2.1±0.5)m/s vs.(4.9±1.7)m/s、(2.2±0.6)m/s vs.(4.6±1.1)m/s],差异均有统计学意义(均P<0.01);同一侧ATFL 3个部位SWV比较差异均无统计学意义。男、女间中立位及跖屈内翻位ATFL 3个部位SWV比较差异均无统计学意义;左、右侧ATFL3个部位SWV比较差异均无统计学意义。对SWE显示为无信号区域的12根ATFL行压迫式弹性成像检查显示,中立位与跖屈内翻位ATFL弹性应变率比值分别为3.63±1.20、14.70±9.07,二者比较差异有统计学意义(P<0.01)。两名医师采用SWE测量中立位与跖屈内翻位ATFL 3个部位SWV的可重复性均较好(ICC≥0.75)。结论超声弹性成像可评估中立位与跖屈内翻位ATFL特征,为ATFL损伤及后期恢复提供量化力学信息。
Objective flexion inversion position of anterior talofibular ligament(ATFL)in normal adults.Methods bilateral ATFL underwent conventional ultrasound and shear wave elastography(SWE).The shear wave velocity(SWV)of ATFL was compared between neutral and plantar flexion inversion in the middle ligament,within 5 mm from fibula attachment and within 5 mm from talus attachment.ATFL with no signal by SWE was examined by compression elastography,and the elastic strain rate ratio of ATFL in the neutral position and plantar-flexion inversion position was compared. Intraclass correlation coefficient(ICC)was used to evaluate inter-observer consistency.Results neutral position.In plantarflexion varus,30 showed red with high stiffiness,and 12 showed no signal filling.Comparison of SWV between neutral and plantar-flexion varus position of the middle of the ligament,within 5 mm of the fibula attachment and within5 mm of the talus attachment[(2.2±0.5)m/s vs.(4.9±1.5)m/s,(2.1±0.5)m/s vs.(4.9±1.7)m/s,(2.2±0.6)m/s vs.(4.6±1.1)m/s]showed significant difference(all P<0.01),but no statistically significant differences between three locations of the same ligament. Different genders and bilateral ATFL comparison showed no significant difference in SWV in neutral and plantarflexion varus position. Compression elastography showed that the strain ratio of ATFL in neutral and plantar-flexion varus position were 3.63±1.20 and 14.70±9.07,and the difference was statistically significant(P<0.01). SWV of ATFL at neutral and plantarflexion position showed good inter-observer repeatability(ICC≥0.75).ConclusionUltrasound elastography can evaluate the characteristics of neutral position and plantar flexion inversion position of ATFL in normal adults,and provide quantitative mechanical information for ATFL injury and recovery.
作者
焦玉婷
崔广和
胡建棣
赵超超
杨智
JIAO Yuting;CUI Guanghe;HU Jiandi;ZHAO Chaochao;YANG Zhi(Department of Ultrasound Medicine,Binzhou Medical University Hospital,Shandong 256600,China)
出处
《临床超声医学杂志》
CSCD
2022年第2期139-142,共4页
Journal of Clinical Ultrasound in Medicine
基金
2017山东省医药卫生科技发展计划项目(2017WS888)。
关键词
超声弹性成像
超声检查
距腓前韧带
正常成人
Ultrasound elastography
Ultrasonography
Anterior talofibular ligament
Normal adult
