CT标准轴位图像对下胫腓前韧带损伤的诊断价值  

Diagnostic Value of Standardized Axial CT Images of Anterior Distal Tibiofibular Ligament Injury

作　　者：王林[1,2] 倪衡建[3] 龚沈初[1,2] 杨巨顺[1,2] 何书[4] 

机构地区：[1]江苏省南通市第一人民医院 [2]南通大学第二附属医院影像科,226001 [3]南通大学临床医学院解剖学教研室,226001 [4]南通大学公共卫生学院统计学教研室

出　　处：《临床放射学杂志》2013年第10期1471-1475,共5页Journal of Clinical Radiology

基　　金：南通市科技局资金支持项目社会事业科技创新与示范(HS2013017)

摘　　要：目的研究CT标准轴位图像对下胫腓前韧带损伤的诊断效能。方法对43例踝关节外伤患者行踝关节CT及MRI扫描,重组CT标准轴位图像,测量胫腓重叠、胫腓间距及其与自身同侧腓骨宽度的比值、前后下胫腓韧带在胫骨结节处的宽度。以MRI结果作为金标准,分析各CT测量参数对下胫腓前韧带损伤的诊断效能。结果共分析了76个踝关节。胫腓重叠及其与同侧腓骨宽度的比值、下胫腓后韧带在胫骨后结节处的宽度及前述3项测量参数的任意叠加组合对下胫腓前韧带损伤有诊断价值;其中以胫腓重叠及其与腓骨宽度比值的诊断价值最高,且两者的诊断效能相当。按胫腓重叠≤3.55 mm的标准,其对下胫腓前韧带损伤的诊断敏感性、特异性分别为96.97%、76.74%。除下胫腓后韧带在胫骨后结节处的宽度外,其余各测量参数或参数组合与下胫腓前韧带损伤程度间均存在相关关系。结论在CT标准轴位图像上,胫腓重叠及其与同侧腓骨宽度的比值、下胫腓后韧带在胫骨后结节顶点处的宽度对下胫腓前韧带损伤有诊断价值,推荐使用胫腓重叠≤3.55 mm作为标准,可为临床诊断下胫腓前韧带损伤提供参考依据。Objective To evaluate the diagnostic value of standardized axial CT images of the anterior distal tibiofibular ligament （ATIFL） injury. Methods Forty-three patients with ankle trauma underwent CT and MR evaluation of ankles, the standardized axial CT images of which were reconstructed, and the measurements included the tibiofibular clear space, tibiofibular overlap （ TFO）, the ratio of items and fibular width （ FW）, and the width of both ATIFL and posterior distal tibiofibular ligament （PTIFL） at the level of the tips of the anterior and posterior tibial tubercle. MR signs were set as gold standard, compared to which was the CT measuring results, and then the diagnostic value of the CT results was analyzed. Results Seventy-six ankles were analyzed. TFO, TFO/FW, the width of PTIFL at the level of the tips of the posterior tib- ial tubercle, and arbitrary combinations of the previous parameters had diagnostic value for ATIFL injuries, TFO and TFO! FW being the highest. The diagnostic sensitivity and specificity was respectively 96.97% and 76.74% when TFO ≤3.55 ram. Apart from the width of PTIFL at the level of the tips of the posterior tibial tubercle, the rest parameters all had regu- lar relations with ATIFL injury degrees. Conclusion On standardized axial CT images, TFO, TFO/FW, and the width of PTIFL at the level of the tips of the posterior tibial tubercle had diagnostic values for ATIFL injuries. TFO ≤ 3.55 mm is recommended as the parameter for diagnosing ATIFL injuries, and which could provide references for clinical diagnosis.

关 键 词：下胫腓前韧带 损伤 踝关节 体层摄影术 X线计算机 

分 类 号：R816.8[医药卫生—放射医学]