高频超声对踝关节侧副韧带损伤的诊断价值研究

CLINICAL VALUE OF HIGH FREQUENCY ULTRASONOGRAPHY IN DIAGNOSING ANKLE LIGAMENTS INJURY

目的探讨高频超声诊断踝关节侧副韧带损伤的临床价值。方法对216例拟诊踝关节侧副韧带损伤患者进行高频超声检查并分型,其中70例手术患者超声检查结果和手术结果进行比较。结果经手术、关节镜及临床随访证实,高频超声检查韧带损伤真阳性125例,假阳性5例,真阴性72例,假阴性14例;敏感率89.92%,特异性93.50%,准确率91.20%,阳性预测值为96.15%,阴性预测值为83.72%。与手术结果对照分析,高频超声诊断侧副韧带Ⅱ型损伤符合率83.33%（χ^2=2.455,P=0.117）;Ⅲ型损伤符合率93.49%（χ^2=1.378,P=0.240）;P值均〉0.05,差异无统计学意义。结论高频超声能够正确诊断踝关节侧副韧带损伤并进行分型,对临床治疗和预后判定具有重要的指导价值。

Objective To study the value of high frequency ultrasonography in the diagnosis of ankle ligaments injury.Methods 216 patients with clinically suspected ankle ligaments injury were examined with high frequency ultrasonographya nd then classified.The ultrasound findings were compared with the surgical results in 70 cases.Results The surgical operation,arthroscopic surgery and clinical follow-up confirmed what the detection of high frequency ultrasonography had found：125cases of ligaments injury were true positive,5cases were false positive,72 cases were true negative,and 14 cases were false negative,with the diagnosis sensitivity being 89.92%,the specificity being 93.50%,the accuracy rate of 91.20%,the positive predictive value being 96.15% and the negative predictive value being 83.72%.Compared with surgical findings,the coincidence rate of high frequency ultrasonography was 83.33%（χ^2=2.455,P=0.117）indetecting Type II ankle ligaments injury and 93.49%（χ^2=1.378,P =0.240）in detecting Type III ankle ligaments injury（P 〉0.05）.Conclusion High frequency ultrasonography can be used to effectively diagnose and classify ankle ligaments injury and can be of great help for treatment and prognosis.