【摘要】 目的：探讨改良斜轴位MRI与高频超声在诊断踝关节距腓前韧带（ATFL）损伤及其严重程度分级中的应用效能。方法：选取2024年3月—2025年1月瑞安市人民医院收治的59例疑似踝关节ATFL损伤患者，均行踝关节改良斜轴位MRI和高频超声检查，根据各自图像评估ATFL损伤情况，并以关节镜结果为“金标准”，比较两项检查对ATFL损伤的检出率及诊断分级结果。结果：关节镜检查结果显示，59例疑似踝关节ATFL损伤患者中阳性55例，阴性4例。改良斜轴位MRI诊断的Kappa值为0.634(P<0.001)，高频超声诊断的Kappa值为0.525(P<0.001)。改良斜轴位MRI与高频超声诊断ATFL损伤的灵敏度、特异度、准确率、阳性预测值、阴性预测值比较，差异无统计学意义（P>0.05）。改良斜轴位MRI检查对Ⅱ级损伤的检出率低于高频超声检查（P=0.037），对Ⅲ级损伤的检出率高于高频超声检查（P=0.016）。结论：改良斜轴位MRI与高频超声对ATFL损伤均具有良好的诊断价值，其中改良斜轴位MRI对Ⅲ级损伤的检出率更高，高频超声对Ⅱ级损伤的检出率更高。更多还原

【Abstract】 Objective: To explore the application efficacy of modified oblique MRI and high-frequency ultrasound in diagnosing and grading the severity of anterior talofibular ligament(ATFL) injuries in the ankle joint. Methods: From March 2024 to January 2025,fifty-nine patients with suspected ATFL injury of the ankle joint admitted to Rui’an People’s Hospital underwent modified oblique axial MRI and high-frequency ultrasound examination of the ankle joint. The ATFL injury was assessed based on the respective images.Using arthroscopy results as the "gold standard", the detection rate and diagnostic grading results of two examinations for ATFL injuries were compared. Results: The results of arthroscopy showed that among 59 patients suspected of having ATFL injury in the ankle joint, 55 were positive and 4 were negative. The Kappa value for the diagnosis using modified obliqueaxialMRIwas0.634(P<0.001),while the Kappa value for the diagnosis using high-frequency ultrasound was 0.525(P<0.001).There was no statistically significant difference in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value between improved oblique axial MRI and high-frequency ultrasound in diagnosing ATFL injury(P>0.05). The detection rate of gradeⅡinjuries using the modified oblique axial MRI examination was lower than that using high-frequency ultrasound(P=0.037), while the detection rate of grade Ⅲ injuries was higher(P=0.016).Conclusion: Both modified oblique axial MRI and high-frequency ultrasound have good diagnostic value for ATFL injuries. Among them, modified oblique axial MRI has a higher detection rate for grade Ⅲ injuries,while high-frequency ultrasound has a higher detection rate for gradeⅡinjuries.更多还原