摘要
目的探讨高频超声(HFUS)与核磁共振成像(MRI)在儿童肘关节微小骨折中的应用价值。方法选取2019年5月至2020年11月本院收治的57例疑似肘关节微小骨折患儿,均行HFUS与MRI检查,根据MRI诊断结果将患儿分为骨折组(n=26)、无骨折组(n=31),比较两组一般资料、超声征象和参数,分析超声征象和参数与儿童肘关节微小骨折关系,探究超声征象和参数诊断儿童肘关节微小骨折的价值。结果 HFUS与MRI诊断儿童肘关节微小骨折的一致性为96.49%,Kappa值为0.942,95%CI:0.765~1.118(P<0.05);骨折组、无骨折组肌肉损伤或血肿、脂肪垫征阳性、关节积液、骨皮质连续性中断分布及肘前脂肪垫厚度比较,差异有统计学意义(P<0.05);肌肉损伤或血肿、脂肪垫征阳性、关节积液、骨皮质连续性中断分布及肘前脂肪垫厚度均与儿童肘关节微小骨折相关(P<0.05);脂肪垫征阳性诊断儿童肘关节微小骨折的敏感度、特异度均为100%;肌肉损伤或血肿、关节积液、骨皮质连续性中断、肘前脂肪垫厚度诊断儿童肘关节微小骨折的AUC分别为0.766、0.699、0.673、0.835。结论 HFUS诊断儿童肘关节微小骨折与MRI结果具有一致性,可直观显示脂肪垫阳性征、肌肉损伤征,为临床诊治儿童肘关节微小骨折提供有效影像学技术支持。
Objective To explore the application value of high frequency ultrasound(HFUS)and magnetic resonance imaging(MRI)in children with microfractures of the elbow joint.Methods From May 2019 to November 2020,57 children with suspected elbow joint microfractures in our hospital were selected for HFUS and MRI.According to the results of MRI diagnosis,children were divided into the fracture group(n=26)and the non⁃fracture group(n=31).The general data,ultrasound signs and parameters of the two groups were compared,and the relationship between the ultrasound signs and parameters and the microfrac⁃tures of the elbow joint in children was analyzed.Results The consistency of HFUS and MRI in the diagnosis of microfractures of the elbow joint in children was 96.49%,the Kappa value was 0.942,and the 95%CI was 0.765~1.118(P<0.05).The comparison of muscle injury or hematoma,positive fat pad sign,joint effusion,cortical bone continuity,and fat pad thickness in front of the elbow between the fracture group and the non⁃fracture group was statistically significant(P<0.05).Muscle injury or hematoma,positive fat pad sign,joint effusion,continuity distribution of cortical bone,and thickness of elbow fat pad were all related to microfrac⁃tures of the elbow joint in children(P<0.05).The sensitivity and specificity of the positive fat pad sign in the diagnosis of microfractures of the elbow joint in children were 100%.The AUC of muscle injury or hemato⁃ma,joint effusion,continuity of cortical bone,and thickness of elbow fat pad for the diagnosis of microfrac⁃tures of the elbow joint in children were 0.766,0.699,0.673,and 0.835,respectively.Conclusion The HFUS diagnosis of microfractures of elbow joints in children is consistent with the MRI results.It can directly display positive signs of fat pads and muscle damage signs,and provide effective imaging technical support for the clinical diagnosis and treatment of microfractures of elbow joints in children.
作者
吴琴芙
黄培楷
肖梦强
李文金
WU Qinfu;HUANG Peikai;XIAO Mengqiang;LI Wenjin(Department of Ultrasound,Zhuhai Hospital,Guangdong Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong,China,519015)
出处
《分子诊断与治疗杂志》
2021年第2期325-328,332,共5页
Journal of Molecular Diagnostics and Therapy
基金
广东省珠海市医学科研基金项目(20191207A010024)。
关键词
肘关节微小骨折
高频超声
核磁共振成像
脂肪垫阳性征
Microfractures of the elbow joint
High⁃frequency ultrasound
Magnetic resonance imaging
Positive fat pad sign
作者简介
通信作者:黄培楷,E⁃mail:6251758@163.com。
