高频超声与剪切波弹性成像在跟腱损伤术后评估中的应用研究

Application of high frequency ultrasound and shear-wave elastography in postoperative evaluation of Achilles tendon injury

目的评估高频超声在跟腱损伤诊断和康复中的临床应用,并通过应用剪切波弹性成像(share wave elastography,SWE)技术对双侧跟腱弹性测值来预测跟腱恢复过程。方法对54例疑似跟腱损伤患者行高频超声检查和SWE检查。40例术后跟腱损伤患者分别于术后第1、3、6个月行高频超声和SWE检查。观察患侧跟腱厚度、回声、血流和剪切波速度值(Shear wave velocity,SWV)变化,并与健侧跟腱作对比。结果54例患者中,高频超声诊断的灵敏度为97.6%(40/41),特异性为76.9%(10/13),准确性为92.6%(50/54)。术后跟腱厚度随时间延长而减少,其内部回声逐渐均匀,血流及粘连情况减少,与临床症状一致。而其剪切波速度值随时间增长逐渐增加。结论高频超声和剪切波速度可以确定跟腱损伤的类型和程度,有助于跟腱损伤的诊断和康复预测。

Objective To evaluate the clinical effect of high-frequency ultrasound in the diagnosis and rehabilitation of Achilles tendon injury and predict the recovery process of Achilles tendon by using share wave elastography(SWE).Methods A total of 54 patients with suspected Achilles tendon injury were examined by high-frequency ultrasonography and SWE.Forty patients with postoperative Achilles tendon injury were examined by high-frequency ultrasonography and SWE at months 1,3 and 6 postoperatively.The thickness,echo,blood flow and shear wave velocity(SWV)of the affected Achilles tendons were observed and compared with those of the healthy Achilles tendon.Results For all the 54 patients,the sensitivity,specificity and accuracy rates of high-frequency ultrasonography were 97.6%(40/41),76.9%(10/13)and 92.6%(50/54),respectively.After surgery,the thickness of the Achilles tendons decreased with time,the internal echo was gradually uniform,and the blood flow and adhesion decreased,which was consistent with the clinical symptoms.The shear wave velocity increased with time.Conclusion High-frequency ultrasound and shear wave velocity can determine the type and degree of Achilles tendon injury,and contribute to its diagnosis and rehabilitation prediction as well.