肌骨超声多个声学征象在原发性冻结肩诊断中的应用价值

摘要/Abstract

摘要： 目的探讨肌骨超声多个声学征象在原发性冻结肩诊断中的应用价值,为促进肌骨超声应用提供参考。方法选择2019年2月—2022年7月在甘肃省庆阳市中医医院参加体检的110名健康人群作为健康对照组,选择2019年2月—2022年7月在甘肃省庆阳市中医医院诊治的110例原发性冻结肩患者作为冻结肩组。所有患者都给予肌骨超声检查,记录声学征象。同时患者给予关节镜检查,对比诊断价值。结果冻结肩组的腱鞘积液、肩袖间隙低回声、关节囊增厚等声学征象占比都明显高于健康对照组,差异有统计学意义（P<0.05）。冻结肩组的冈上肌腱、冈下肌腱和肌筋膜厚度都显著高于健康对照组,差异有统计学意义（P<0.05）。冻结肩组的肌骨超声半定量评分为显著高于健康对照组,差异有统计学意义（P<0.05）。在冻结肩组与健康对照组220例入选者中,肌骨超声判断为冻结肩114例,肌骨超声多个声学征象在原发性冻结肩诊断中的敏感性与特异性分别为99.09%（109/110）和95.45%（105/110）,Kappa值为0.945。结论原发性冻结肩多伴随有肌骨超声腱鞘积液、肩袖间隙低回声、关节囊增厚等声学征象,同时伴随有滑膜血流特征异常,肌骨超声对于原发性冻结肩的诊断敏感性与特异性都比较高。

关键词: 原发性冻结肩, 肌骨超声, 声学征象, 滑膜血流特征, 关节镜, 诊断价值

Abstract: Objective To explore the application values of multiple acoustic signs of musculoskeletal ultrasound in the diagnosis of primary frozen shoulder, to provide a reference for promoting the application of musculoskeletal ultrasound. Methods From February 2019 to July 2022, 110 patients with primary frozen shoulder who were diagnosed and treated in Qingyang Traditional Chinese Medicine Hospital of Gansu Province were selected as the frozen shoulder group, and 110 healthy people who participated in physical examination From February 2019 to July 2022 in Qingyang Traditional Chinese Medicine Hospital of Gansu Province were selected during the same period. as a healthy control group. All patients were underwent musculoskeletal ultrasonography, and acoustic signs were recorded. At the same time, patients were given arthroscopy, and were to determine the diagnostic value. Results The acoustic signs such as hydrocele, hypoechoic rotator cuff space, and joint capsule thickening in the frozen shoulder group which were significantly higher than those in the healthy control group (P<0.05). The thickness of supraspinatus tendon, infraspinatus tendon and myofascia in frozen shoulder group were significantly higher than those in healthy control group (P<0.05). The musculoskeletal ultrasound semi-quantitative score in the frozen shoulder group was significantly higher than that in the healthy control group (P<0.05). Among the 220 patients in the frozen shoulder group and the healthy control group, 114 cases were diagnosed as frozen shoulder by musculoskeletal ultrasound, and the sensitivity and specificity of multiple acoustic signs of musculoskeletal ultrasound in the diagnosis of primary frozen shoulder were 99.09% (109/110) and 95.45% (105/110), the Kappa value is 0.945. Conclusion Primary frozen shoulder is often accompanied by musculoskeletal ultrasound tendon hydrocele, hypoechoic rotator cuff space, joint capsule thickening and other acoustic signs, as well as abnormal synovial blood flow characteristics. Musculoskeletal ultrasonography has high sensitivity and specificity for the diagnosis of primary frozen shoulder.

Key words: primary frozen shoulder, musculoskeletal ultrasound, acoustic signs, synovial blood flow characteristics, arthroscopy, diagnostic value

中图分类号:

R445

王薇. 肌骨超声多个声学征象在原发性冻结肩诊断中的应用价值[J]. 中华养生保健, 2023, 41(10): 15-19.

WANG Wei. The Application Values of Multiple Acoustic Signs of Musculoskeletal Ultrasound in the Diagnosis of Primary Frozen Shoulder[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(10): 15-19.

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