肌骨超声对儿童急性踝关节扭伤韧带损伤分级及其他合并损伤的诊断价值OA
Diagnostic Value of Musculoskeletal Ultrasound in Grading Ligament Injuries and Detecting Other Combined Injuries in Children with Acute Ankle Sprain
目的 探讨肌骨超声对儿童急性踝关节扭伤韧带损伤分级及其他合并损伤的诊断价值.方法 回顾性选取 2023 年 4月至 2025 年 8 月于我院就诊的 100 例急性踝关节扭伤患儿作为研究对象,均行肌骨超声检查与MRI检查.以MRI检查结果作为诊断标准,评价肌骨超声对儿童急性踝关节扭伤韧带损伤分级及其他合并损伤的诊断情况.结果 100 例患儿均存在距腓前韧带损伤,MRI检查显示:46 例为Ⅰ度损伤,51 例为Ⅱ度损伤,3 例为Ⅲ度损伤;肌骨超声检查显示:42 例为Ⅰ度损伤,56 例为Ⅱ度损伤,2 例为Ⅲ度损伤.一致性分析显示,肌骨超声诊断距腓前韧带损伤分级的结果与MRI 检查结果一致性良好(Kappa=0.712).ROC 曲线分析结果显示,肌骨超声诊断≥Ⅱ度距腓前韧带损伤的灵敏度为 94.44%,特异度为 84.78%,准确度为90.00%,AUC为 0.930(95%CI:0.839～0.930,P＜0.001).对于关节腔积液、肌腱损伤、骨骺损伤及外踝骨骺撕脱性骨折,MRI检查的检出率分别为 100.00%、30.00%、75.00%、48.00%,肌骨超声检查的检出率分别为 98.00%、26.00%、68.00%、60.00%,两种方法检出率比较,差异无统计学意义(P＞0.05).结论 肌骨超声能准确判断儿童急性踝关节扭伤中距腓前韧带损伤的严重程度,且其对该韧带损伤分级的诊断与MRI检查结果一致性良好;同时,肌骨超声可有效检出关节腔积液、肌腱损伤、骨骺损伤及外踝骨骺撕脱性骨折等伴随病变,其检出结果与MRI检出结果无明显统计学差异.因此,肌骨超声可作为儿童急性踝关节扭伤的有效诊断手段.
Objective To investigate the diagnostic value of musculoskeletal ultrasound(MSUS)in grading ligament injuries and detecting other combined injuries in children with acute ankle sprain.Methods A total of 100 children with acute ankle sprain who were treated in our hospital from April 2023 to August 2025 were retrospectively selected as the research objects.All children underwent both MSUS and magnetic resonance imaging(MRI)examinations.Taking MRI findings as the diagnostic standard,the diagnostic performance of MSUS in grading ligament injuries and identifying other combined injuries in children with acute ankle sprain was evaluated.Results All 100 children had anterior talofibular ligament(ATFL)injury.MRI showed 46 cases of grade Ⅰ injury,51 cases of grade Ⅱ injury,and 3 cases of grade Ⅲ injury;MSUS showed 42 cases of grade Ⅰ injury,56 cases of grade Ⅱ injury,and 2 cases of grade Ⅲ injury.Consistency analysis revealed good agreement between MSUS and MRI in grading ATFL injury(Kappa=0.712).Receiver operating characteristic(ROC)curve analysis showed that MSUS had a sensitivity of 94.44%,specificity of 84.78%,accuracy of 90.00%,and an area under the curve(AUC)of 0.930(95%CI:0.839～0.930,P<0.001)for diagnosing grade≥Ⅱ ATFL injury.For joint effusion,tendon injury,epiphyseal injury,and avulsion fracture of the lateral malleolar epiphysis,the detection rates were 100.00%,30.00%,75.00%,and 48.00%by MRI,and 98.00%,26.00%,68.00%,and 60.00%by MSUS,respectively,with no statistically significant difference between the two methods(P>0.05).Conclusions MSUS can accurately assess the severity of ATFL injury in children with acute ankle sprain,with good consistency with MRI results in injury grading.Meanwhile,MSUS can effectively detect accompanying lesions such as joint effusion,tendon injury,epiphyseal injury,and avulsion fracture of the lateral malleolar epiphysis,with no significant statistical difference compared to MRI findings.Therefore,MSUS can be used as an effective diagnostic tool for acute ankle sprain in children.
冼小云;黄小川;黎呈芳;蔡勇时;梁儿敏
中山火炬开发区人民医院超声医学科,广东 中山 528400中山火炬开发区人民医院超声医学科,广东 中山 528400中山火炬开发区人民医院超声医学科,广东 中山 528400中山火炬开发区人民医院放射医学中心,广东 中山 528400中山火炬开发区人民医院放射医学中心,广东 中山 528400
医药卫生
肌骨超声磁共振急性踝关节扭伤韧带损伤其他合并损伤儿童
Musculoskeletal ultrasoundMagnetic resonance imagingAcute ankle sprainLigament injuryOther combined injuryChild
《临床医学工程》 2026 (4)
386-390,5
中山市医学科研项目(项目编号:20231A020103)
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