IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, Milan, Italy.
Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy.
Semin Musculoskelet Radiol. 2020 Apr;24(2):125-134. doi: 10.1055/s-0039-3401042. Epub 2020 May 21.
Musculoskeletal (MSK) ultrasound has well-established advantages, able to investigate very small structures with high resolution and a quick and real-time dynamic evaluation with the possibility of contralateral comparison. Thus ultrasound has kept its own almost exclusive fields of application in daily clinical practice, and it is considered the first-level imaging technique to assess tendons, bursae, and capsuloligamentous structures of small peripheral joints as well as peripheral nerves. Up to now, however, clinical MSK ultrasound imaging could not go beyond the first 1 to 2 cm under the skin, using high-frequency probes up to 18 to 20 MHz with spatial resolution just below millimeters. We present the impressive technical advancements leading to image resolution as low as 30 µm using ultra-high frequency ultrasound (UHFUS) probes up to 70 MHz. High-frequency ultrasound and UHFUS, with frequencies ranging from 22 to 70 MHz, are promising tools to evaluate very superficial structures. In the MSK system, only two articles have assessed its value in limited case series. Future developments may be aimed to better assess ultrastructural changes of very superficial peripheral nerves and other thin structures such as pulleys, retinacula, and tendons.
肌肉骨骼（MSK）超声具有良好的优势，能够以高分辨率检查非常小的结构，并进行快速实时的动态评估，且具有对侧比较的可能性。因此，超声在日常临床实践中保持了自己几乎独一无二的应用领域，它被认为是评估小关节周围的肌腱、滑囊和囊韧带结构以及周围神经的一级成像技术。然而，到目前为止，临床 MSK 超声成像只能使用高达 18 到 20 MHz 的高频探头，在皮肤下 1 到 2 厘米的范围内进行，空间分辨率仅略低于毫米。我们展示了令人印象深刻的技术进步，使用高达 70 MHz 的超高频率超声（UHFUS）探头可以实现低至 30 µm 的图像分辨率。高频超声和 UHFUS 的频率范围从 22 到 70 MHz，是评估非常浅层结构的有前途的工具。在 MSK 系统中，只有两篇文章在有限的病例系列中评估了其价值。未来的发展可能旨在更好地评估非常浅层的周围神经和其他薄结构（如滑车、支持带和肌腱）的超微结构变化。
