高频超声对坐骨结节周围疾病的诊断价值

目的探讨坐骨结节周围病变的高频超声声像图特点及高频超声检查特异性。方法 41例坐骨结节周围病变患者,均经临床确诊,其中男性18例,女性23例;年龄8个月～67岁,平均年龄40岁(标准差1.2岁)。采用高频探头进行纵、横、斜切扫查,回顾性分析临床及高频超声影像资料,将资料分为坐骨结节滑膜囊肿、感染性病变、肿瘤性及肿瘤样病变、软组织损伤4大类,分析各类疾病的声像图特点及超声检查特异度。结果高频超声对坐骨结节周围病变的显示率100.0%(41/41),诊断符合率为82.9%(34/41),其中高频超声对坐骨结节滑膜囊肿诊断符合率为87.5%(7/8),对感染性病变诊断符合率为91.3%(21/23),对肿瘤性及肿瘤样病变诊断符合率为55.6%(5/9)。结论高频超声对坐骨结节滑膜囊肿及感染性病变具有较高的特异性,对肿瘤性及肿瘤样病变特异性较低。因坐骨结节周围软组织损伤病例少,对其特异性有待观察。高频超声对坐骨结节周围疾病的检查具有很高的临床应用价值,可作为首选的影像学检查方法。

High frequency ultrasound in the diagnosis of lesions around ischial tuberosity

Objective To investigate the features of high-frequency ultrasound imaging of the lesions around ischial tuberosity and the specificity of high frequency ultrasound. Methods A total of 41 patients with lesions around ischial tuberosity were enrolled, which included 18 males and 23 females, aged 8-month to 67 years old（mean age 40.0 years）. All the patients in the current study were confirmed by clinical diagnosis. Vertical, horizontal and oblique scanning with high frequency probe were performed and the clinical and high frequency ultrasound image data were retrospectively analyzed. The data were divided into 4 types, synovial cyst of ischial tuberosity, infectious lesion, tumor and phymatoid lesion, and soft tissue injury. The uhrasonography characteristic and examinational specificity of high frequency ultrasound for each kind of disease were analyzed. Results The detected rate of lesions around ischial tuberosity was 100.0 %（41/41） and diagnosis coincidence rate was 82.9 %（34/41） by high frequency ultrasound,and the diagnosis coincidence rate was 82.9 %（7/8） for synovial cyst of ischial tuberosity, 91.3 %（21/23） for infectious lesion, and 55.6 %（5/ 9） for tumor and phymatoid lesion. Conclusion It is demonstrated that high frequency ultrasound has a considerably high specificity for synovial cyst of ischial tuberosity and infectious lesion, but a relatively lower specificity for tumor and phymatoid lesion. Its specificity for soft tissue injury needs to be further observed due to fewer cases with soft tissue injury of ischial tuberosity in the current study. The high frequency ultrasound examination is of high clinical value for the diagnosis of the lesions around ischial tuberosity and could be used as a preferred imaging method.