高频超声对肱骨外上髁炎诊断价值

目的探讨高频超声对肱骨外上髁炎的超声诊断价值。方法应用高频超声检查我院临床诊断肱骨外上髁炎患者17例及对照10例。结果高频超声能满意显示肱骨外上髁及伸肌总腱的细微解剖与病变情况,对临床诊断提供可靠依据。结论高频超声诊断肱骨外上髁炎简便、价廉、准确,值得提倡推广。     

肱骨外上髁炎的高频超声表现

目的总结肱骨外上髁炎患者伸肌总腱的高频超声声像图表现。方法回顾性分析75例肱骨外上髁炎患者的高频超声声像资料,观察伸肌总腱厚度、肌腱内部回声、病变处血流信号及伸肌总腱附着处肱骨外上髁骨质情况。结果 5例高频超声未见明显异常;余70例高频超声表现为伸肌总腱增厚45例,肌腱内部回声局限性减低35例,肌腱内部点状强回声钙化灶22例,伸肌总腱止点处不同程度撕裂19例,伸肌总腱附着处肱骨外上髁骨刺形成4例,骨皮质不规整10例,患肘伸肌总腱病变处见血流信号48例。结论高频超声可清晰显示网球肘患者伸肌总腱的声像图改变,病变位置、范围,评估病变严重程度,为诊断提供可靠依据。     

彩色多普勒超声对肱骨外上髁炎的诊断价值

目的利用彩色多普勒超声检查(CDUS)观察肱骨外上髁炎(LE)患者肘关节外上髁的超声表现,评价CDUS对LE的诊断价值。方法对27例临床诊断为LE患者的27个患侧肘关节和18例对照者25个正常肘关节行超声检查,观察肱骨外上髁伸肌总腱的厚度、内部回声、有无钙化、撕裂以及内部血流情况,肱骨外上髁骨质是否光整、有无毛糙,并进行对比分析。结果对照组伸肌总腱平均厚度约(0.40±0.06)cm,LE组伸肌总腱平均厚度约(0.56±0.13)cm,较对照组明显增厚,差异有统计学意义(t=-5.43,P<0.01)。病变伸肌总腱回声减低,内部可有钙化或撕裂,彩色血流信号较对照组明显增多。肱骨外上髁骨皮质回声毛糙、不光整。结论 CDUS对肱骨外上髁炎具有一定的诊断价值,在临床应用中可作为诊断肱骨外上髁炎的首选检查方法。     

高频肌骨超声辅助诊断肱骨外上髁炎的应用价值

目的 探讨高频肌骨超声（MSUS）辅助诊断肱骨外上髁炎的应用价值。方法 回顾性分析单侧肘关节有肱骨外上髁炎的患者35例,将高频MSUS提示为肱骨外上髁炎的肘关节纳入观察组,对侧正常的肘关节作为对照组。比较两组肘关节肱骨外上髁处伸肌总腱的高频超声声像图表现,包括伸肌总腱的厚度、肌腱内部回声情况、肌腱内部血流分布、肌腱附着处骨皮质等情况。结果 两组肘关节肱骨外上髁处伸肌总腱的厚度比较,差异有统计学意义（P<0.05）。两组肌腱回声不均匀、局部回声减低的高频超声表现,差异有统计学意义（P<0.05）。肌腱内有无血流信号表现,组间差异有统计学意义（P<0.05）。肌腱附着处骨皮质的改变,组间差异有统计学意义（P<0.05）。肌腱内见小撕裂表现,组间差异有统计学意义（P<0.05）。结论 高频MSUS检查可以辅助诊断肱骨外上髁炎,为临床医生提供较为客观的诊断依据。     

超声对网球肘的诊断价值

目的 总结网球肘患者伸肌总腱和肱骨外上髁的声像图表现,评价超声检查对网球肘诊断的价值.方法 84例经临床诊断为网球肘患者治疗前行超声检查.通过患侧与健侧对比,灰阶声像图指标包括:伸肌总腱厚度,回声,撕裂(无回声纤维缺损区),有无钙化,肱骨外上髁骨质改变;对比观察伸肌总腱血流信号(增加,无改变).28例随后行手术治疗.结果 7例超声未发现异常,77例患侧灰阶声像图或彩色多普勒表现异常.该病超声表现为:伸肌总腱肿胀增厚71.4％(55/77),局部回声减低53.2％ (41/77),撕裂39.0％ (30/77),77.9％ (60/77)可探及血流信号增加.撕裂患者中,位于深层者86.7％ (26/30),远大于浅层13.3％ (4/30).23例(30.0％)可见钙化,18例(23.4％)肱骨外上髁骨质有不规则改变或骨刺样隆起.超声对撕裂的范围、位置与手术记录一致.结论 超声检查不仅能发现网球肘患者伸肌总腱的病变,还能评价病变的位置,范围,评估疾病的严重程度,彩色多普勒血流显像可评估是否为急性充血期.     

肱骨外上髁炎的超声诊断价值

肱骨外上髁炎亦称网球肘,是引起肘部疼痛的常见病,临床诊断多以病史及体格检查为主。本研究旨在探讨肱骨外上髁炎时伸肌总腱的超声改变及病变程度,对临床诊断、鉴别诊断提供帮助。 资料与方法 一、临床资料 2007年3月至2009年3月我院肘部疼痛拟诊为肱骨外上髁炎患者87例,男24例,女63例,年龄25～81岁,平均52岁。患者均为单侧发病。     

顽固性肱骨外上髁炎的手术治疗(附11例报告)

肱骨外上髁炎往称“网球肘”,近年来黄、陈二氏谓之“桡侧腕伸肌肌起损伤”。翻阅资料,治病方法不同,手术方法均较复杂。本组对反复保守治疗效果不佳的11例患者施行“肱骨外上髁伸肌总腱起点剥离术”获得较满意效果。介绍如下:     

艾灸治疗肱骨外上髁炎

肱骨外上髁炎俗称“网球肘”。祖国医学统称为“肘痛”,是肱骨外上髁部伸肌总腱处的慢性损伤性肌筋膜炎。本病通常发生于长期从事单一动作的劳动者,例如:木工、泥工、竹工、钳工等。此病临床上较为常见。我们用艾灸治疗肱骨外上髁炎51例,疗效较好,     

针刀药综合治疗肱骨外上髁炎34例疗效观察

肱骨外上髁炎又称“网球肘”，是指肱骨外上髁部伸肌总腱处的慢性损伤性肌筋膜炎。临床上较常见。笔者自1989年以来用小针刀加局部注射磷酸川芎嗪的方法治疗数十例收到了较好的效果，现将资料较完整的34例总结如下。     

顽固性网球肘20例核磁表现及其临床意义分析

网球肘又名肱骨外上髁炎,一般认为是由于肱骨外上髁伸肌总腱的慢性劳损或牵拉引起,是一种常见多发的疾病,临床上大多根据病史、肘外侧的疼痛点及Mill试验等做出明确的诊断^[1]。客观的诊断指标文献未见报道,我们分析了20例手术证实网球肘患者的核磁表现,     

Diagnostic value of ultrasonography for clinical medial epicondylitis

Park G-Y, Lee S-M, Lee MY. Diagnostic value of ultrasonography for clinical medial epicondylitis.

Objectives

To assess the ultrasonographic findings and to evaluate the value of ultrasonography as a diagnostic method for detecting clinical medial epicondylitis.

Design

A prospective, single-blind study.

Setting

An outpatient rehabilitation clinic in a tertiary university hospital.

Participants

Twenty-one elbows from 18 patients with clinical medial epicondylitis and 25 elbows without medial epicondylitis were evaluated.

Interventions

Not applicable.

Main Outcome Measures

The clinical diagnosis of medial epicondylitis was based on the patient’s symptoms and clinical signs in a physical examination performed by a physiatrist. An experienced radiologist made the real-time ultrasonographic diagnosis based on the detection of at least one of the following abnormal findings: a focal hypoechoic or anechoic area, tendon nonvisualization, intratendinous calcifications, and cortical irregularity.

Results

Ultrasonography revealed positive findings in 20 of 21 elbows with medial epicondylitis and was negative in 23 of 25 without medial epicondylitis. Ultrasonography showed sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for clinical medial epicondylitis of 95.2%, 92%, 93.5%, 90.9%, and 95.8%, respectively. Tendinosis was observed in 15 elbows, and a partial-thickness tear, including 1 intrasubstance tear, was detected in 5 elbows. The most common ultrasonographic abnormality was a focal echogenic abnormality (15 hypoechoic, 5 anechoic) of the tendons.

Conclusions

Our results indicate that ultrasonography is informative and accurate for the detection of clinical medial epicondylitis. Therefore, ultrasonography should be considered as an initial imaging method for evaluating medial epicondylitis.     

高频超声诊断冈上肌腱撕裂

目的 观察冈上肌腱撕裂超声声像图特征,评估高频超声诊断冈上肌腱撕裂的效能.方法 纳入65例(65肩)超声诊断为冈上肌腱撕裂患者,以同期10名健康志愿者(20肩)为对照,对比超声与关节镜术中诊断结果,采用Cohen's Kappa系数分析二者诊断的一致性,评价超声诊断效能.结果 冈上肌腱撕裂超声多表现为无回声、肌腱滑囊面...     

Coeliac disease in patients with cerebellar ataxia of unknown origin

BACKGROUND. Neurological symptoms of unknown origin are common in coeliac disease (CD). Evidence suggests that CD may also contribute to the development of idiopathic late-onset ataxia.

AIM. To evaluate the frequency of CD in patients with cerebellar ataxia of unknown origin.

METHODS. The medical files of adult patients with the diagnosis of cerebellar ataxia of unknown origin (n = 44) were evaluated. Serum gliadin, endomysial, and serum tissue transglutaminase antibodies were used as screening tests for CD. Subjects with positive results were referred to small-bowel biopsy.

RESULTS. The frequency of CD was as high as 9.1% in all patients. A thorough interview and review of the patient files indicated alcohol abuse as a cause for cerebellar disease in almost half (45.5%) of our patients. When the cases with alcohol abuse were omitted, the calculated frequency of CD was 16.7% in patients with ataxia of unknown origin.

CONCLUSION. CD is a common association with cerebellar disease and the disease should be considered in all patients with ataxia of unknown origin.     

Comparison of sonography and MRI for diagnosing epicondylitis

PURPOSE: The aim of this prospective study was to compare the sensitivity and specificity of sonography with those of MRI in evaluating epicondylitis. METHODS: The affected elbows of 11 patients with suspected epicondylitis were examined sonographically, and the contralateral (normal) elbow was also examined for comparison. In 10 of these patients, the affected elbow was also examined with MRI. In addition, both elbows of 6 volunteers without epicondylitis were examined sonographically; 1 elbow of each volunteer was designated as the "test" elbow and was examined with MRI. The sonograms of the patients' affected elbows and the volunteers' test elbows were paired with the sonograms of the contralateral elbows for comparison and were randomly shown twice to 2 readers. These readers, working independently and without knowledge of the findings of MRI, were instructed to state whether each elbow was normal or affected by epicondylitis. The MRI scans were then shown to the readers for similar review. RESULTS: Sonographic features of epicondylitis included outward bowing of the common tendon, presence of hypoechoic fluid subadjacent to the common tendon, thickening, decreased echogenicity, and ill-defined margins of the common tendon. Sensitivity for detecting epicondylitis ranged from 64% to 82% for sonography and from 90% to 100% for MRI. Specificity ranged from 67% to 100% for sonography and from 83% to 100% for MRI. CONCLUSIONS: Sonography is as specific but not as sensitive as MRI for evaluating epicondylitis. Used as an initial imaging tool, sonography might be adequate for diagnosing this condition in many patients, thus allowing MRI to be reserved for patients with symptoms whose sonographic findings are normal.     

颈横动脉超声检测方法的初步研究

目的　探讨颈横动脉的超声检测方法及其在临床中的应用价值。方法　用二维及彩色多普勒超声技术对5 0条正常人的颈横动脉进行检测。结果　二维及彩色多普勒超声显示颈横动脉自锁骨下动脉发出的占 6 8% ;能显示出甲状颈干占 30 % ;有 1例右侧可见两条颈横动脉直接起自锁骨下动脉 ,占 2 %。颈横动脉起始部内径分别为 2 .32± 0 .6 0mm(L) ,2 .4 3± 0 .5 8mm(R)。血流频谱显示呈快速二相波或三相波。结论　超声可以很好地显示颈横动脉起始、走行方向等形态学特征及血流动力学信息。在头面部、颈部及口腔外科术的术前超声检查对临床的病例筛选及选择手术方法有重要意义。     

高频探头联合端扫式凸阵腔内探头经会阴超声诊断肛瘘

目的 探讨高频探头联合端扫式凸阵腔内探头经会阴超声对肛瘘的诊断价值。方法 回顾性分析87例接受手术治疗的肛瘘患者，术前均采用频率5~12 MHz线阵探头超声结合触诊和视诊检查外口和瘘管，频率3~10 MHz端扫式凸阵腔内探头经会阴超声检查内口和瘘管，确定肛瘘类型，分析超声与手术结果的一致性。结果 87例中，手术诊断单纯型肛瘘73例、复杂型肛瘘14例，术中见93个内口，101个瘘管，94个外口。超声诊断66例肛瘘，漏诊15例，误诊6例，与手术结果的符合率为75.86%（66/87），Kappa值为0.344（P<0.001）。超声诊断肛瘘内口、瘘管及外口的准确率分别为80.65%（75/93）、83.17%（84/101）及87.23%（82/94），与手术结果一致性的Kappa值分别为0.298、0.407及0.626（P均<0.001）。结论 高频探头联合端扫式凸阵腔内探头经会阴超声检查有助于诊断肛瘘。     

输尿管囊肿的影像学诊断

目的评价静脉尿路造影(IVU)、CT与B超对输尿管囊肿的诊断价值.方法回顾性分析25例输尿管囊肿的IVU、CT及B超检查资料.25例均行IVU、B超检查,4例行CT检查.结果全部病例均经手术病理证实.左侧10例,右侧7例,双侧8例.IVU显示膀胱内边界清晰的充盈缺损7例,17例呈"眼镜蛇头"征,诊断正确率为96%(24/25).B超显示囊肿呈类圆形无回声暗区21例,形态可随排尿而改变,诊断正确率为92%(23/25).结论 IVU结合超声检查诊断输尿管囊肿可靠性高,二者相互补充,可对此病做出准确诊断.     

超声诊断及鉴别诊断儿童迷走甲状腺

目的 探讨高频超声对儿童迷走甲状腺的诊断价值。 方法 回顾性分析10例分别经核素扫描、超声引导下穿刺活检、手术及随访证实的迷走甲状腺患儿的临床及超声表现。结果 二维超声诊断迷走甲状腺6例,经核素扫描及随访证实;迷走甲状腺伴桥本甲状腺炎2例,经超声引导下穿刺活检证实;颈部包块1例,术前穿刺活检证实为迷走甲状腺伴结节性甲状腺肿;甲状舌管囊肿1例,术后病理为迷走甲状腺伴结节性甲状腺肿囊性变。结论 超声对儿童迷走甲状腺的诊断及鉴别诊断具有重要临床意义。