Kälebo P, Goksör L A, Swärd L, Peterson L
Department of Diagnostic Radiology, Ostra Sjukhuset, Gothenburg, Sweden.
Acta Radiol. 1990 Nov;31(6):565-70.
Ultrasonography (US) was compared with soft-tissue radiography (STR) and computed tomography (CT) for demonstration of partial Achilles tendon ruptures. Thirty-nine patients suffering from chronic localized painful Achilles tendon swelling were examined. The patients had all undergone a previous clinical examination, resulting in a suspicion of a non-healed partial tear in 62 out of the 78 tendons. STR showed unspecific tendon pathology such as thickening and diffuse tendon margins. CT resulted in a better delineation of intra- as well as extratendinous abnormalities compared to STR. Various pathologic changes were seen on CT in 54 tendons and in 29 of these, localized intratendinous hypodensities indicated partial ruptures. At US, abnormal changes were observed in 69 tendons, of which 54 had discontinuity of tendon fibers, focal hypoechoic areas, and localized swelling indicating partial ruptures. In 9 cases with surgically proven partial ruptures, US was correct in all cases, while CT was false-negative in 3. STR only showed localized swelling. It was concluded that US was a better method than STR and CT for the detection of partial ruptures and the US findings correlated well with the surgical findings.
为了显示跟腱部分断裂，对超声检查（US）、软组织X线摄影（STR）和计算机断层扫描（CT）进行了比较。对39例患有慢性局限性疼痛性跟腱肿胀的患者进行了检查。所有患者均接受过先前的临床检查，78条肌腱中有62条怀疑存在未愈合的部分撕裂。STR显示出非特异性的肌腱病变，如增厚和肌腱边缘模糊。与STR相比，CT能更好地显示肌腱内及肌腱外的异常情况。54条肌腱在CT上可见各种病理改变，其中29条肌腱内局限性低密度影提示部分断裂。在超声检查中，69条肌腱观察到异常改变，其中54条有肌腱纤维连续性中断、局灶性低回声区和局限性肿胀，提示部分断裂。在9例经手术证实为部分断裂的病例中，超声检查在所有病例中均正确，而CT有3例假阴性。STR仅显示局限性肿胀。得出的结论是，在检测跟腱部分断裂方面，超声检查比STR和CT更好，且超声检查结果与手术结果相关性良好。
