학술논문
高频超声对类风湿性跟腱病的诊断价值 / High-frequency Ultrasonography in Diagnosis of Rheumatoid Achilles Tendinopathy
Document Type
Academic Journal
Author
陈仕宇; 臧国礼; 许伟莹; 冯朱斌; 赵佳; 徐庆; 胡闽; 武凯敏; CHEN Shiyu; ZANG Guoli; XU Weiying; FENG Zhubin; ZHAO Jia; XU Qing; HU Min; WU Kaimin
Source
中国医学影像学杂志 / Chinese Journal of Medical Imaging. 25(9):702-706
Subject
Language
Chinese
ISSN
1005-5185
Abstract
目的 探讨高频超声(HFUS)对类风湿性关节炎(RA)跟腱病的诊断价值.资料与方法 回顾性分析67例共93足的跟腱HFUS表现,其中健康对照组11例22足(A组),RA跟腱病组36例40足(B组)和非RA跟腱病组20例31足(C组).应用HFUS观察跟腱部位的灰阶声像图(GSI)和能量多普勒显像(PDI)特征分析并比较各组:①跟腱GSI异常阳性率;②跟腱起点、中点和止点的厚度和宽度;③跟骨后滑囊积液检出率;④跟腱内血流信号检出率;⑤血流信号的等级.结果 ①跟腱GSI异常阳性率:A组与B组差异无统计学意义(x2=0.064,P＞0.05),C组比A组和B组更易出现异常(x2=31.601、39.256,P＜0.05);②跟腱径值测量:c组各点横切面厚度均较A、B组增大(P＜0.05),各组间横切面宽度差异均无统计学意义(P＞0.05);③跟骨后滑囊积液检出率:A组未检出,B组(55.0％)检出率高于C组(19.4％),差异有统计学意义(P＜0.05);④跟腱内血流信号检出率:A组未检出,B组(97.5％)检出率高于C组(45.2％),差异有统计学意义(P＜0.05);⑤血流信号等级:Ⅰ级检出率B组(7.5％)低于C组(35.5％),Ⅱ级检出率B组(35.0％)高于C组(9.7％),差异均有统计学意义(P＜0.05),Ⅲ级检出率仅B组45.0％,C组未检出.另外对3例PDI显示Ⅲ级血流信号累及跟腱脂肪垫的患者进行穿刺活检,发现病理结果与超声表现一致.结论 HFUS诊断RA跟腱病具有较高的应用价值,并能够与非RA原因所致跟腱病进行鉴别,可以协助临床早诊断、早治疗,避免跟腱断裂等不良进展.
Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.
Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.