Comparative Analysis Of The Application Value Of High Frequency Ultrasound And MRI In The Diagnosis Of Talofibular Ligament Injury

Objective To evaluate the value of high-frequency ultrasound in the diagnosis of acute ATFL injury of by comparing with MRI,,and to provide clinical guidance.Methods A total of 92 patients who were suspected with ATFL damage from July2018 to March 2021 were included.All patients underwent HFUS and MRI before arthroscopy which was used as the gold standard,and the diagnostic value of HFUS and MRI on the degree of ATFL damage was compared with arthroscopy.ROC curve was used to analyze the efficacy of HFUS and MRI in the diagnosis of ATFL injury.And the detection rates of OLT,tendon injury and fracture of the bone were compared between the two methods.The thickness of the change of ATFL was measured by HFUS,Then value was measured for the the application of HFUS in acute injury of ATFL.Results A total of 92 patients were confirmed varying degrees ATFL damage by arthroscopy(48 cases with completely torn,40 cases with partial tear,4 cases of ligament injury).The sensitivity,specificity and accuracy of HFUS in the diagnosis partial tear of ATFL were 75%,85% and 80% respectively;the sensitivity specificity and accuracy in complete tear were 85%,80% and 85% respectively.The sensitivity,specificity and accuracy of oblique axial MRI in ATFL partial tear were 79%,88% and 86% respectively;the sensitivity,specificity and accuracy were 83%,84% and 85% in completely torn.Chi-square test was performed between HFUS and MRI in diagnosing partial tear and complete tear of ATFLin groups,and there was no significant statistical difference(P>0.05).ROC curve analysis showed that the AUC of HFUS and MRI were 0.833 and 0.854 respectively,the difference was not statistically significant(P>0.05).Both HFUS and MRI could well judge the joint cavity effusion and tendon injury of ligament,and the difference was not statistically significant(P>0.05),but the diagnosis of osteochondral injury and fracture by HFUS was inferior to MRI,and the difference was statistically significant(P<0.05).The high-frequency ultrasound value of ATFL thickness in the diseased side was 4.28±0.52mm,and that in the healthy side was 2.38±0.36mm,and there was a statistically significant difference between the two groups(P<0.01).Conclusion 1.HFUS has a good diagnosis value for acute injury of ATFL,and it can be effectively applied to the severity of the damage of ATFL diagnosis,it can be used as a routine examination for clinical guide 2.The detection rate of HFUS for combined tendon injury and joint cavity effusion is high,but it is inferior to MRI for combined OLT fracture,but HFUS can also be used as an important auxiliary examination.HFUS can accurately and reliably measure ligament thickness.By dynamically observing the change of injury thickness of ATFL,the healing and recovery of the ligament can be understood,so as to guide the implementation of the rehabilitation plan and determine the time of return to exercise and full weight bearing.