超声诊断先天性马蹄内翻足  

Ultrasonographic diagnosis of congenital clubfoot

作　　者：方静[1] 陈亚青[1] 赵黎[2] 曾颖淇[1] 李銮[1] 

机构地区：[1]上海交通大学医学院附属新华医院超声科,上海200092 [2]上海交通大学医学院附属新华医院小儿骨科,上海200092

出　　处：《中国医学影像技术》2013年第1期101-104,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超声诊断先天性马蹄内翻足(CCF)的应用价值。方法收集18例CCF患儿,按照病变累及范围分为单侧CCF组(10例)和双侧CCF组(8例),选取同期因其他原因就诊的10名健康婴儿作为对照组。行双足超声检查,测量自然位、内收位、外展位时内踝至足舟骨(MMN)距离,计算3组自然位-内收位、自然位-外展位、内收位-外展位MMN距离的差值,进行统计学比较。结果超声发现CCF患足内侧骨排列异常,自然位时内侧斜冠状切面声像图显示距骨近端被内踝覆盖,舟骨半脱位跨于距骨远端上方;患足内侧软组织较厚,距骨位置较深,内收、外展活动受限。双侧CCF组与对照组、单侧CCF组患足与对侧健足自然位、内收位、外展位时MMN距离及自然位-内收位、自然位-外展位、内收位-外展位MMN距离的差值差异均有统计学意义(P均<0.05)。结论超声可直观显示CCF患足内侧骨异常排列,动态观察并评估患足内收、外展活动受限情况。Objective To assess the value of ultrasonography in diagnosis of congenital clubfoot （CCF）. Methods Eighteen infants with CCF were divided into unilateral CCF group （n=10） and the bilateral CCF group （n=8） according to the range of lesions involving. Ten healthy infants were selected as the control group. Ultrasonography was performed to both feet in all infants. The medial malleolar-navicular （MMN） distances at the neutral position, maximal adduction and maximal abduction position were measured, and then the differences of the natural-adducent, natural-abducent and adducent-abducent MMN distance （MMN-difference） were calculated and compared statistically. Results The medial tarsal deformities were found by ultrasonography in all clubfeet. The ultrasonogram of medial oblique coronal aspect showed that the proximal end of talus was covered by malleolus medialis in the neutral position, subluxation navicular crossed above the remote end of talus. Medial soft tissue of clubfeet became thicker, the position of talus became deeper, and the flexibility of the medial foot was limited. Compared with MMN distances and MMN-difference with the normal foot at all positions, those of clubfeet were all significantly different （all P〈0.05）. Conclusion Ultrasonography can visualize the abnormal medial tarsal anatomy. Dynamic foot ultrasonography is useful for evaluating the mobility of CCF.

关 键 词：足畸形 先天性 超声检查 

分 类 号：R682.19[医药卫生—骨科学] R445.1[医药卫生—外科学]