CAJ | 학술논문

目的：探讨高频超声对腕背部囊肿的诊断价值。方法回顾136例经手术及术后病理结果证实为腕背部囊肿的超声图像资料，分析其发生部位与声像图特征。结果高频超声诊断腕背部囊肿136例，根据发生解剖层次的不同可分为伸肌支持带囊肿、伸肌腱滑液鞘囊肿和骨间背侧韧带囊肿，所占百分比分别为1.5%（2/136）、24.3%（33/136）和74.2%（101/136）。囊肿具体发生部位排在前3位的是舟月背侧韧带、指伸肌腱及示指伸肌腱滑液鞘、桡侧腕长及腕短伸肌腱滑液鞘，所占百分比分别为60.3%（82/136）、8.1%（11/136）和6.6%（9/136）。腕背部囊肿具有典型的声像图表现：二维灰阶超声显示伸肌支持带囊肿体积较小，呈椭圆形无回声区，边界清晰，位于水肿增厚的伸肌支持带内，与伸肌腱无联系，多同时合并舟月背侧韧带囊肿；伸肌腱滑液鞘囊肿位于伸肌腱旁，呈椭圆形或茄形包绕肌腱，与骨间背侧韧带及伸肌支持带无联系，骨间背侧韧带呈正常的条索状回声，表面光滑、平整；骨间背侧韧带囊肿呈不规则形无回声区，位于受损韧带浅方，受损韧带增厚、回声减低，表面不光整，内部条索状回声连续性完全中断或部分中断致局部变细。彩色多普勒血流成像示腕背部囊肿内均无血流信号。结论高频超声能够对腕背部囊肿作出准确的定位诊断，可作为指导临床治疗首选的影像学检查方法。
목적：탐토고빈초성대완배부낭종적진단개치。방법회고136례경수술급술후병리결과증실위완배부낭종적초성도상자료，분석기발생부위여성상도특정。결과고빈초성진단완배부낭종136례，근거발생해부층차적불동가분위신기지지대낭종、신기건활액초낭종화골간배측인대낭종，소점백분비분별위1.5%（2/136）、24.3%（33/136）화74.2%（101/136）。낭종구체발생부위배재전3위적시주월배측인대、지신기건급시지신기건활액초、뇨측완장급완단신기건활액초，소점백분비분별위60.3%（82/136）、8.1%（11/136）화6.6%（9/136）。완배부낭종구유전형적성상도표현：이유회계초성현시신기지지대낭종체적교소，정타원형무회성구，변계청석，위우수종증후적신기지지대내，여신기건무련계，다동시합병주월배측인대낭종；신기건활액초낭종위우신기건방，정타원형혹가형포요기건，여골간배측인대급신기지지대무련계，골간배측인대정정상적조색상회성，표면광활、평정；골간배측인대낭종정불규칙형무회성구，위우수손인대천방，수손인대증후、회성감저，표면불광정，내부조색상회성련속성완전중단혹부분중단치국부변세。채색다보륵혈류성상시완배부낭종내균무혈류신호。결론고빈초성능구대완배부낭종작출준학적정위진단，가작위지도림상치료수선적영상학검사방법。
ObjectiveTo evaluate the diagnostic value of high-frequency ultrasonography for dorsal wrist cyst.MethodsThe ultrasonographic characteristics of 136 dorsal wrist cysts were retrospectively studied and compared with the pathological results, the locations and the imaging characteristics of the cysts were analysed, hence to conclude the diagnostic value of high-frequency ultrasonography.ResultsBased on the anatomical location diagnosed by high frequency ultrasound, the 136 dorsal cysts were divided into three types: extensor retinaculum cysts, synovial tendon sheath cysts and dorsal interosseous ligament cysts, each accounted for 1.5% (2/136), 24.3% (33/136) and 74.2% (101/136) of the study group. The most frequently detected locations for dorsal cysts were dorsal scapholunate ligament,tendinous sheath of extensor digitorum and extensor indicis, as well as tendinous sheath of extensor carpi radialis longus and brevis,each accounted for 60.3% (82/136), 8.1% (11/136) and 6.6% (9/136) of all dorsal wrist cysts respectively. Dorsal wrist cysts had typical ultrasonographic features on 2-D gray-scale ultrasonography, the extensor retinaculum cyst demonstrated as a well-marginated, small-sized and oval anechoic area, which was commonly located in the oedematous extensor retinaculum, but it had no adjunction with the extensor tendon, and it was accompanied with dorsal scapholunate ligment cyst frequently. Synovial tendon sheath cyst demonstrated as a oval or eggplant-shaped anechoic area which was usually winding around the extensor tendon, but it had no adjunction with the dorsal interosseous ligament and the extensor retinaculum. Meanwhile, the dorsal interosseous ligament appeared to be normal strip-like echo texture with a smooth and clear margin. Dorsal interosseous ligament cyst demonstrated as a out-of-shape anechoic area and located superior to the injured ligament. Meanwhile, the impaired ligament was thickened with uneven margin and decreased echo texture. No blood lfow signals was detected in all dorsal wrist cysts by color doppler lfow imaging.ConclusionHigh-frequency ultrasonography can be used to diagnosis dorsal wrist cysts, and can be served as the preferred imaging modelity to guide the clinical treatment.