Abstract：Objective: To compare the diagnostic efficacy of high-frequency ultrasound (HFUS) and real-time shear wave elastography (SWE) in diagnosing acute anterior talofibular ligament (ATFL) injury and to explore the advantages of diagnostic methods for clinical diagnosis of the disease. Methods: A total of 80 patients with suspected acute ATFL injury of the ankle joint were collected from March 2021 to April 2023. All patients underwent HFUS and SWE ultrasound elastography examination before surgery. The arthroscopy examination results were used as the gold standard for diagnosis. The diagnostic value of HFUS and SWE in acute ATFL injury was compared, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of HFUS and SWE for acute ATFL injury. The detection rates of joint effusion, talar cartilage injury, tendon injury, and fracture were also compared. Results: ①All 80 patients were confirmed to have injuries by arthroscopy, including 42 cases of complete tear, 35 cases of partial tear, and 3 cases of ligament injury. In the HFUS examination, there were 47 cases of complete tear, 30 cases of partial tear, and 3 cases of ligament injury. In the HFUS combined with SWE examination, there were 43 cases of complete tear, 35 cases of partial tear, and 2 cases of ligament injury. ②Taking the arthroscopy examination results as the gold standard, the consistency analysis was performed using SPSS software. The consistency test results showed that the kappa coefficient of consistency between HFUS and arthroscopy diagnosis was 0.644 (P < 0.001), and there was no statistical difference between the two in I degree injury (χ2 = 0.000, P = 1.000), II degree injury (χ2 = 0.648, P = 0.421), and III degree injury (χ2 = 0.633, P = 0.426). The Kappa coefficient of consistency between HFUS combined with SWE and arthroscopy diagnosis was 0.857 (P < 0.001), and there was no statistical difference between the two in I degree injury (χ2 = 0.206, P = 1.000), II degree injury (χ2 = 0.000, P = 1.000), and III degree injury (χ2 = 0.025, P = 0.874). ③The area under the curve (AUC) of HFUS for I degree injury was 0.827, and the AUC of HFUS combined with SWE for I degree injury was 0.833, with no statistical difference (P > 0.05); the AUC of HFUS for II degree injury was 0.802, and the AUC of HFUS combined with SWE for II degree injury was 0.938, with statistical difference (P < 0.05); the AUC of HFUS for III degree injury was 0.831, and the AUC of HFUS combined with SWE for III degree injury was 0.949, with statistical difference (P < 0.05). ④There was no statistical difference in the detection rates of joint effusion, talar cartilage injury, and tendon injury between HFUS and HFUS combined with SWE (P > 0.05); the detection rate of fracture was statistically different (P < 0.05). Conclusion: HFUS combined with SWE has high clinical value in diagnosing acute ATFL injury, and it has high judgment ability for injury grading, and it can also be used to judge the combined injury of the ankle joint.
毛佶, 胡泽莹, 朱贤胜. 高频超声与实时剪切波弹性成像诊断急性距腓前韧带损伤的临床价值[J]. 河北医学, 2024, 30(4): 597-603.
MAO Ji, HU Zeying, ZHU Xiansheng. Clinical Value of High Frequency Ultrasound and Real Time Shear Wave Elastography in Diagnosis of Acute Anterior Talofibular Ligament Injury. HeBei Med, 2024, 30(4): 597-603.
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2024, Vol. 30 
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