跗跖关节断层标本与MRI对比分析  

Comparative analysis on anatomy of normal tarsometatarsal joint with MRI and sectional specimen

作　　者：张泽坤[1] 贾晓英[2] 吴文娟[1] 任国山[3] 陈伟[4] 李玉清[1] 崔蕴威[1] 

机构地区：[1]河北医科大学第三医院放射科,河北石家庄050051 [2]河北省人民医院急诊科 [3]河北医科大学解剖教研室 [4]河北医科大学第三医院骨科

出　　处：《实用放射学杂志》2013年第1期85-87,154,共4页Journal of Practical Radiology

基　　金：河北省卫生厅医学科学研究重点课题（20090407）.

摘　　要：目的 与正常跗跖关节标本断层解剖对比，评价MRI在分析跗跖关节解剖关系的作用。方法 从标本中取6个正常足，采用德国SIEMENS公司1．5T超导型磁共振机，用T1-vibe序列和FLASH序列，分别行斜横断面、冠状面和矢状面扫描。随机分成A、B、C3组，每组2个标本，对标本进行包埋、固定，行斜横断面、冠状面和矢状面铣切，厚度0．5mm，用相机连续拍照，保存图像。对标本的MR图像及解剖断层图像进行对照观察。结果 MR扫描能够清晰地显示跗跖关节各结构的排列情况，第2、4跖骨从底的内侧缘分别与中间楔骨、骰骨内侧缘形成连续光滑的连线，跗跖关节的背侧缘为连续光滑的连线，Lisfrane韧带明显比跖侧跖跗韧带粗大，背侧跖跗韧带最为薄弱。斜横断面能够清晰地显示Lisfranc韧带长轴以及跖间、跗间韧带，冠状面能够最示Lisfranc韧带断面以及跖间、跗间韧带，矢状面能够显示跖侧、背侧韧带，Lisfranc韧带显示不理想。MR图像能够很好地与断层图像相对应。结论 MR能够可靠地显示跗跖关节各结构的解剖关系，特别是对韧带的显示更具有优越性。Ohjective To evaluate the effectiveness of MRI in analyzing the anatomical features of tarsometatarsal（TMT） joints in comparison with sectional anatomical TMT specimen. Methods Six normal fresh feet specimens were selected. T1-VIBE and FI.ASH MR sequences were employed to obtain the sagittal, coronal, and transverse oblique sections by using SIEMENS 1.5T MR scanner. The specimens were divided into three groups （Group A, B, and C） with two specimens each group. The specimens were embedded, fixed and frozen in different positions, which were milled with a thickness of 0. 5mm to obtain sagittal, coronal, and transverse oblique sections, respeclively. Digital images of all sections were taken by a camera. MR images of the specimens were compared with the sectional images of the specimens. Results The arrayal of the components of TMT joints could be demonstrated by MR imaging. The medial border of the bases of the second and forth metatarsal bones,the medial border of the intermediate cune iform bone and the cuboid bone formed as a continuous and smooth line. The dorsal surface of TMT joint appeared as a continuous and smooth line. The lisfrane ligament was significantly thicker and bigger than the plantar part of TMT ligament. The dorsal part of TMT ligament was the weakest. The transverse oblique images could clearly show the long axis of Lisfranc ligament, the intertarsal anti intermetatarsal ligaments. The coronal images could show the section of the Lisfranc ligament, the intertarsal and intermetatar sal ligaments. The plantar dorsal ligaments could he showed clearly on the saggital images. Lisfranc ligament could not he demon strated on the saggital images clearly. MR images were in high concordance with the sectional images. Conclusion MR imaging can demonstrate the components and their anatomical relationship of TMT joints. MRI has the superiority in demonstrating ligaments.

关 键 词：跗跖关节 解剖 磁共振成像 

分 类 号：R323.72[医药卫生—人体解剖和组织胚胎学] R445.2[医药卫生—基础医学]