Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings
Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings
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DOI：
10.1259/bjr.20130406
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发表时间：
2014-01-01
影响因子：
2.6
通讯作者：
Wang, Y.
中科院分区：
文献类型：
--
作者：
Cheng, Y.;Cai, Y.;Wang, Y.
目的：探讨超声诊断慢性踝关节外侧韧带损伤的准确性。方法：对120例临床怀疑为慢性踝关节韧带损伤的患者，术前采用5 ~ 17 mhz线阵换能器对120例踝关节进行超声检查。超声检查结果与手术表现进行比较。结果：距腓骨前韧带扭伤18例，部分撕裂24例，完全撕裂52例；跟腓韧带（CFL）扭伤26例，部分撕裂27例，完全撕裂12例；经关节镜及手术治疗后距腓骨后韧带完全撕裂1例。与手术检查结果相比，超声检查对ATFL损伤的敏感性、特异性和准确性分别为98.9%、96.2%和84.2%，对CFL损伤的敏感性、特异性和准确性分别为93.8%、90.9%和83.3%。超声检查发现PTFL撕裂。急性对慢性和亚急性慢性患者之间的识别准确性没有差异。三级ATFL损伤的诊断准确率与CFL损伤的诊断准确率基本一致。结论：超声检查对踝关节扭伤后慢性疼痛的诊断提供了有用的信息。知识进展：术中发现是参考标准。我们证明了超声检查在检测踝关节慢性外侧韧带损伤方面具有高度的敏感性和特异性。
Objective: The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury.Methods: A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings.Results: There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute-chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries.Conclusion: Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain.Advances in knowledge: Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint.