多参数超声检查对足底筋膜炎应用分析

The study of multiparametric ultrasonography for the plantar fasciitis

目的 探讨超声灰阶成像与超声实时组织弹性成像对足底筋膜炎的诊断价值,观察超声在评估慢性足底筋膜炎中的临床应用。方法 选取我院收治的足底筋膜炎患者38例(48只足)作为实验组,并选择26例健康志愿者(52只足)作为对照组。分别记录两组的性别、年龄、BMI、灰阶超声(厚度、回声高低、是否有钙化、筋膜内ROI中最高频率亮度水平和平均亮度水平)及彩色超声特征(筋膜血流)及超声实时组织弹性成像特征(计算观测部位与周围软组织的弹性应变比),评估二维灰阶成像与超声实时组织弹性成像对足底筋膜炎的诊断价值。结果 实验组筋膜厚度、弹性应变比均较对照组高,差异有统计学意义(P<0.001),实验组与对照组比较,筋膜回声减低,差异有统计学意义(P<0.001),实验组筋膜内ROI中最高频率亮度水平及平均亮度水平均低于对照组,差异有统计学意义(P<0.001,P=0.030)。结论 超声实时组织弹性成像能清晰显示、量化足底筋膜炎患者的筋膜弹性变化,有重要的诊断价值,联合二维灰阶超声可观察足底筋膜回声、厚度以及硬度的改变,为足底筋膜炎的诊断提供依据。

Objective To investigate the diagnostic value of ultrasound gray-scale imaging and ultrasound real-time tissue elastography in plantar fasciitis,and to observe the clinical application of ultrasound in the evaluation of chronic plantar fasciitis.Methods Thirty-eight patients(48 feet)with plantar fasciitis admitted to Guang'anmen Hospital from September 2021 to June 2022 were collected as the study group,and 26 healthy volunteers(52 feet)were selected as the control group.Gender,age,BMI,gray scale ultrasound(thickness,echo level,calcification,highest frequency brightness level and average brightness level in the intrafascial ROI),color ultrasound features(fascial blood flow)and real-time tissue elastography features(calculation of strain ratio of the relative surrounding soft tissue)were recorded in the two groups,respectively.We evaluated the diagnostic value of two-dimensional gray scale imaging and real-time tissue elastography in plantar fasciitis.Results The fascia thickness and elastic strain ratio in the study group were higher than those in the control group(P<0.001).The fascia echo in the study group was lower than that in the control group(P<0.001).The highest frequency brightness level and average brightness level in the ROI in the study group were lower than those in the control group(P<0.001,P=0.030).Conclusion Real-time ultrasound elasticity can clearly show and quantify the changes of fascia elasticity in patients with plantar fasciitis,which has important diagnostic value.Combined with two-dimensional grey-scale ultrasound,the changes of plantar fascia echo,thickness and hardness can be observed,which provides a basis for the diagnosis of plantar fasciitis.