Department of Ultrasound, Shandong Medical Imaging Research Institute, Jinan, Shandong, China (mainland).
Department of Rehabilitation, Liaocheng People's Hospital, Liaocheng, Shandong, China (mainland).
Med Sci Monit. 2017 Dec 4;23:5752-5759. doi: 10.12659/msm.904186.
BACKGROUND This study evaluated the clinical application of high-frequency color Doppler ultrasonography (HFCDU) in the diagnosis, treatment, and rehabilitation of Achilles tendon injury. MATERIAL AND METHODS A total of 68 patients with suspected Achilles tendon injury were examined by HFCDU. There were 42 Achilles tendon injury patients who underwent surgery, and they were randomly divided into a routine treatment group (n=21) and a rehabilitation group (n=21). HFCDU was performed at weeks 1, 3, 6, and 9, and months 3, 6, 9, 12, and 24 after the operation. The thickness of the injured Achilles tendon, echo, blood flow, and tissue adhesion were compared to those of the uninjured side. RESULTS Of the 68 patients, 14 had normal ultrasound presentation with strong echo; 7 had laceration, presenting as swelling and decreased echo; 26 had partial tear, presenting as discontinued rupture with no or low echo; 19 had complete rupture, presenting as discontinued fibers with hypoechoic hemorrhage and hyperechoic fat tissue between ends; 1 had plantar tendon rupture and periapical hemorrhage; and 1 had acute Achilles tendonitis. The postoperative tendon thickness decreased over time, echo turned homogeneous, blood flow and adhesions decreased, and these results were consistent with clinical symptoms. Patient condition and ultrasound recovery were better in the rehabilitation group, and the diameter of the injured tendon increased compared with the uninjured side. CONCLUSIONS HFCDU can determine the types and extent of tendon injuries, and can help in the diagnosis, treatment, and rehabilitation of Achilles tendon injury.
本研究评估高频彩色多普勒超声(HFCDU)在跟腱损伤的诊断、治疗和康复中的临床应用。
对 68 例疑似跟腱损伤患者进行 HFCDU 检查。其中 42 例跟腱损伤患者接受手术治疗,随机分为常规治疗组(n=21)和康复组(n=21)。术后第 1、3、6、9 周及第 3、6、9、12、24 个月进行 HFCDU 检查,比较患侧与健侧跟腱厚度、回声、血流及组织粘连情况。
68 例患者中,14 例超声表现正常,回声强;7 例有撕裂,表现为肿胀,回声降低;26 例部分撕裂,表现为连续性中断,无或低回声;19 例完全撕裂,表现为纤维连续性中断,回声为低回声出血,两端为高回声脂肪组织;1 例跟腱断裂合并跖肌腱撕裂和根尖出血;1 例急性跟腱炎。术后腱厚度随时间逐渐变薄,回声逐渐均匀,血流和粘连减少,这些结果与临床症状一致。康复组患者病情和超声恢复情况较好,与健侧相比,患侧跟腱直径增加。
HFCDU 可确定跟腱损伤的类型和程度,有助于跟腱损伤的诊断、治疗和康复。