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目的 观察疲劳性跖骨骨折的超声表现,探讨超声在其早期诊断和随访中的临床价值.方法 回顾性分析30例经X线和CT随访证实疲劳性跖骨骨折患者的临床表现及声像图特征.结果 30例均为第2或第3跖骨干不全性骨折,超声随访3个月,骨皮质由增厚、边缘毛糙、针状或线状低回声、“蘑菇状”或“菜花状”隆起,逐渐变为骨表面光滑、“丘状”或“半球形”隆起.彩色多普勒早期见局部骨膜及软组织内血流信号丰富,骨痂形成期骨皮质及周围组织内见条状或迂曲走形丰富血流信号,改造塑型期血流信号减少或消失.结论 超声不仅能观察骨皮质连续性,而且能显示疲劳性骨折愈合过程中骨痂动态变化及血流灌注特征.

Objective To observe the ultrasonic manifestation of metatarsal fatigue fractures and probe into the clinical values of ultrasonic diagnosis and follow-up to the disease.Methods The clinical data and sonographic features of 30 cases with metatarsal fatigue fracture confirmed by X-ray and CT were analyzed retrospectively.Results All the subjects in this study were metatarsals insufficiency fractures located in the second or third diaphysis.2D-ultrasound found microfracture in the cortex and the periosteal elevation by increased vascularity in the early stage.During the 3-month follow-up,thickened cortex and callus shown as the shape of mushroom or cauliflower and a great amount of neovascularisation were visualised with color Doppler flow imaging.Then,the cortex surface became gradually changing from rough to smooth and obvious posterior shadows were observed with the illness progression.Conclusions Ultrasonography could be used to detect the cortical continuity,callus characteristics and blood flow perfusion of fatigue fracture in the different damage stages.