Abstract:

Objective　To explore the clinical application value of ultrasound in the diagnosis of Morel-Lavallée lesions, and to provide a convenient and effective diagnosis method for clinic surgeons. Methods　The clinical data of 48 patient with Morel-Lavallée lesions who received preoperative ultrasound and magnetic resonance examination in Binzhou Medical University Hospital from January 2012 to January 2022 were retrospectively analyzed, including 20 males and 28 females, aged (45.6±5.8) years, 26 cases of lower limbs, 9 cases of upper limbs, 8 cases of pelvis and hips, and 5 cases of lumbar back. The lesion size range (maximum transverse diameter and maximum longitudinal diameter) of Morel-Lavallée lesions on preoperative ultrasound and magnetic resonance examination and the lesion size range (maximum transverse diameter and maximum longitudinal diameter) of clinical surgical exploration were analyzed and compared. The diagnostic accuracies of preoperative ultrasound and magnetic resonance examination for Morel-Lavallée lesions were calculated. The consistency test of Kappa coefficient was used to evaluate the diagnostic coincidence rate between the results of ultrasound and magnetic resonance examination and postoperative pathological results. Results　By comparing the size of lesions detected during clinical operation with the results of preoperative ultrasound diagnosis, it was found that 45 cases were basically identical, and 3 cases had an error of about 2 cm in the longitudinal and axial distance, with a diagnostic accuracy of 93.75%. By comparing the size of lesions detected during clinical operation with the results of preoperative MRI diagnosis, it was found that the size of lesions diagnosed by MRI was almost identical in 46 cases, and there was an error of about 2 cm in the horizontal axis in 2 cases, with a diagnostic accuracy of 95.83%. The diagnostic coincidence rate of ultrasound examination and postoperative pathological results was 97.92%. The diagnostic coincidence rate of MRI and postoperative pathological results was 100.00%. Among them, one patient had a long time of lesion, and the postoperative pathological results suggested the malignant transformation of cyst wall histiocytes, which could not be confirmed by ultrasound diagnosis, but the magnetic resonance diagnosis suggested the possibility of malignant transformation of cyst wall histiocytes. Conclusions　Ultrasound is of great value in the diagnosis of Morel-Lavallée lesions, especially for patients with residual metal in the body who cannot complete magnetic resonance examination. It can not only clarify the size of and nature of lesions, has a high diagnostic accuracy. The diagnostic operation is simple, convenient for patients to complete the examination in time, worthy of clinical application.

Key words:

Ultrasonic diagnosis, Morel-Lavallée lesions, Ultrasonic Medicine, Clinical value

摘要：

目的　探讨超声用于诊断Morel-Lavallée损伤的临床应用价值，为临床提供便捷有效的诊断方法。方法　回顾性分析2012年1月至2022年1月滨州医学院附属医院收治的48例术前接受超声和磁共振检查的Morel-Lavallée损伤患者的临床资料。其中男20例、女28例，年龄（45.6±5.8）岁；下肢26例，上肢9例，骨盆部及髋部8例，腰背部5例。分析比较患者的术前超声检查及磁共振检查Morel-Lavallée损伤的病变大小范围（最大横径和最大纵径）和临床手术探查的病变大小范围（最大横径和最大纵径），计算术前超声及磁共振检查Morel-Lavallée损伤的诊断准确率。通过Kappa系数一致性检验评估超声检查结果和磁共振检查诊断结果与术后病理结果的诊断符合率。结果　临床手术术中探查病变范围大小与术前超声诊断结果相比较发现，其中45例基本完全一致，3例存在纵轴距离约2 cm的误差，诊断准确率为93.75%。临床手术术中探查病变范围大小与术前磁共振诊断结果相比较发现，其中46例基本完全一致，2例存在横轴距离约2 cm的误差，诊断准确率为95.83%。超声检查结果与术后病理结果的诊断符合率为97.92%；磁共振检查诊断结果与术后病理结果的诊断符合率为100.00%。其中1例患者病变时间较久，术后病理结果提示囊壁组织细胞恶变，超声诊断未能明确该诊断，而磁共振诊断结果提示存在囊壁组织细胞恶变可能。结论　超声对于Morel-Lavallée损伤的诊断具有重要价值，尤其是对于体内存留金属无法完成磁共振检查的患者。超声不但可以明确病变部位的大小范围及病变性质，具有较高的诊断准确率，而且诊断操作简单，方便患者及时完成检查，值得临床推广应用。

关键词:

超声诊断, Morel-Lavallée损伤, 超声医学, 临床价值