踝关节骨折X线与MRI诊断下胫腓联合损伤的相关性分析  

Correlation between radiodiagnosis and MRI on the injury of the distal tibiofibular syndesmosis of ankle fractures

作　　者：陈斌[1,2] 骆宇春[1,2] 耿承军[1,3] 杨晓亮[1,3] 于长春[1,4] 邹明[1,2] 柏广富[1,2] 

机构地区：[1]安徽医科大学无锡临床学院 [2]解放军第101医院骨科,江苏无锡214044 [3]解放军第101医院放射科,江苏无锡214044 [4]解放军第101医院南京军区军事训练医学研究所,江苏无锡214044

出　　处：《中国矫形外科杂志》2012年第22期2023-2026,共4页Orthopedic Journal of China

摘　　要：[目的]评估急性踝关节骨折X线测量与MRI诊断下胫腓联合损伤的相关性,为临床诊治下胫腓联合损伤提供建议和方法。[方法]56例急性踝关节骨折均行Denis-weber分型和Lauge-Hansen分型,骨折分型结合X线测量评定下胫腓联合损伤,MRI作为参照标准来评估下胫腓联合的完整性,以此来统计分析X线检查发现下胫腓损伤相对于MRI的敏感性和特异性,并对X线测量值与韧带损伤进行Spearman等级相关分析。[结果]Denis-weber分型中结合测量值,发现下胫腓联合损伤的敏感性为49%,特异性为100%,Lauge-Hansen分型的敏感性为93%,特异性为94%,下胫腓间隙和下胫腓重叠阴影不与下胫腓联合损伤成完全对应关系,增宽的距骨内踝间隙不与三角韧带损伤成对应关系。[结论]根据Lauge-Hansen骨折分型判断下胫腓联合损伤与MRI表现更接近;与X线检查相比,MRI能更准确地评估下胫腓联合损伤的严重程度。[ Objective] To evaluate the correlation between radiographic measurements and syndesmotie injury on MRI of a- cute ankle fractures to provide suggestions and methods for clinical diagnosis and treatment. [ Method ] The radiographs of 56 consecutive ankle fractures were classified according to Denis-Weber and Lauge-Hansen prospectively. Both the fracture type and additional measurements were used to assess syndesmotic injury. MRI, as standard of reference, were performed to evaluate the integrity of the tibiofibular syndesmosis. The sensitivity and specificity for detection of syndesmotic injury with radiography were compared to MRI, and Spearman rank correlation analysis between radiographic measurements and the extent of the syndes- motic injury were performed. [ Result ] The Denis - Weber fracture classification system, in combination with additional measure- ments,was used to detect syndesmotic injury with a sensitivity of 49% and a specificity of 100% , and Lauge -Hansen with a sensitivity of 93% and a specificity of 94%. TFCS and TFO did not absolutely correlate with syndesmotic injury,and a widened MCS did not correlate with deltoid ligament injury. [ Conclusion] Syndesmotic injury as predicted by the Lauge -Hansen frac- ture classification correlated well with MRI findings. With MRI the extent of syndesmotic injury can be assessed more accurately compared to radiographs.

关 键 词：X线 MRI 踝关节骨折 骨折分型 下胫腓联合损伤 等级相关分析 

分 类 号：R683.42[医药卫生—骨科学]