Balius Ramon, Rodas Gil, Pedret Carles, Capdevila Lluís, Alomar Xavier, Bong David A
Sport Catalan Council, Generalitat de Catalunya, Barcelona, Spain.
Skeletal Radiol. 2014 Jun;43(6):805-12. doi: 10.1007/s00256-014-1856-z. Epub 2014 Mar 14.
To assess the sensitivity of ultrasound in detecting soleus muscle lesions diagnosed on magnetic resonance imaging (MRI) and to characterize their location, ultrasound pattern, and evolution.
Ultrasound and MRI studies were performed between May 2009 and February 2013 on all patients who presented to the Medical Services Clinic of the Catalan Sport Council with the initial onset of sharp pain in the calf compatible with injury of the soleus muscle. An inter-observer ultrasound reliability study was also performed.
A total of 55 cases of soleus injury were studied prospectively (22 with right leg involvement, 33 left) by ultrasound and MRI, which was utilized as the "gold standard." In MRI studies, 24 cases (43.7%) had myofascial injuries that were localized in the posterior aponeurosis (PMF) in 15 cases (27.3%) and in the anterior aponeurosis (AMF) in 9 (16.4%). Thirty-one cases (56.3%) were musculotendinous injuries, with 9 cases (16.4%) in the medial aponeurosis (MMT), 11 cases (20%) in the lateral aponeurosis (LMT), and 11 cases (20%) in the central tendon (CMT). In comparison to MRI, ultrasound was able to detect injury to the soleus in 27.2% of cases. No injuries were detected by ultrasound alone. Posterior myofascial injuries were more likely to be detected by ultrasound than anterior myofascial injuries or all types of musculotendinous injuries. Ultrasound patterns for each type of injury were described.
Ultrasound is not a sensitive technique for detecting and assessing soleus traumatic tears compared with MRI, although the sensitivity is enhanced by a thorough anatomically based ultrasound examination. Timing of the ultrasound examination may be of importance. Each type of soleus injury appears to have a characteristic ultrasound pattern based on a defect of connective expansions, the existence of small myofascial filiform collections, and the rarefaction of the fibrillar area.
评估超声检测经磁共振成像（MRI）诊断的比目鱼肌损伤的敏感性，并对其位置、超声表现及演变特征进行描述。
2009年5月至2013年2月期间，对所有因小腿突发剧痛且初诊为比目鱼肌损伤而前往加泰罗尼亚体育委员会医疗服务诊所就诊的患者进行了超声和MRI检查。同时还进行了超声检查者间可靠性研究。
共对55例比目鱼肌损伤患者进行了前瞻性研究（22例右侧受累，33例左侧受累），以MRI作为“金标准”进行超声和MRI检查。在MRI检查中，24例（43.7%）为肌筋膜损伤，其中15例（27.3%）位于后腱膜（PMF），9例（16.4%）位于前腱膜（AMF）。31例（56.3%）为肌腱肌肉损伤，其中9例（16.4%）位于内侧腱膜（MMT），11例（20%）位于外侧腱膜（LMT），11例（20%）位于中央肌腱（CMT）。与MRI相比，超声仅能在27.2%的病例中检测到比目鱼肌损伤。单独超声检查未发现损伤。后肌筋膜损伤比前肌筋膜损伤或所有类型的肌腱肌肉损伤更易被超声检测到。描述了每种损伤类型的超声表现。
与MRI相比，超声检测和评估比目鱼肌创伤性撕裂并不敏感，尽管基于解剖学的全面超声检查可提高敏感性。超声检查的时机可能很重要。基于结缔组织扩张缺陷、小肌筋膜丝状聚集物的存在以及纤维区域的稀疏，每种比目鱼肌损伤似乎都有其特征性的超声表现。
