男性职业足球运动员踝关节损伤影像学特征分析  

Imaging study of ankle injury in professional soccer player of males

作　　者：李绍林[1] 赵文吉[1] 郝帅[1] 胡绍勇[1] 张锐[1] 张鑫涛[1] 

机构地区：[1]南方医科大学第三附属医院医学影像科广东省骨科研究院骨关节医学影像研究所,广州510630

出　　处：《中华医学杂志》2015年第17期1290-1294,共5页National Medical Journal of China

摘　　要：目的 分析男性职业足球运动员踝关节损伤影像学表现.方法 2014年3月至2015年1月间以本地区职业足球俱乐部32名足球运动员作为研究对象,均为男性,平均年龄19～ 33（22.0±3.0）岁,开始从事专业足球训练的平均年龄4～14（8.6 ＋2.0）岁,从事足球运动时间平均7 ～27（13 ＋4）年.X线检查踝关节正位片和侧位片;CT检查常规扫描后在图像处理工作站上行轴位、冠状位、矢状位重组;MR检查使用飞利浦Achieva Dual 1.5 T超导MR,踝关节专用相控阵线圈,快速自旋回波序列行常规横轴位T2WI;冠状位T1WI;冠状位质子密度加权成像（PWI）;矢状位T2加权加脂肪抑制成像;各向同性加脂肪抑制的快速场回波序列矢状位PWI.结果 28例51侧踝关节完成X线检查;26例52侧踝关节完成CT检查;30例51侧踝关节完成MR检查;X和CT发现距骨异常改变最为常见,其中后缘“海豚嘴”样突出35侧（发生率68.6％）;外缘三角形凸起45侧（发生率88.2％）,内踝骨赘5侧,外踝骨赘8侧,后踝游离体12侧.MR显示距腓前韧带损伤30侧（发生率58.8％）;距腓后韧带损伤26侧（发生率51.0％）;跟腓韧带损伤25侧（发生率49.0％）;后踝滑膜炎和局部积液29侧（发生率56.9％）;三角韧带多数为部分损伤,以前组和浅层容易损伤,完全损伤发生率较低（仅3侧）.肌腱损伤以腱鞘炎较常见,踇长屈肌腱18侧、胫后肌腱13侧、趾长屈肌腱7侧、腓骨长肌腱5侧、腓骨短肌腱2侧、跟腱病变6侧.结论 职业足球运动员长期大运动量的训练和比赛容易导致骨骼、韧带和肌腱发生解剖结构和病理改变,多数是以慢性损伤为主.影像学检查能发现踝关节异常,有利于帮助运动员、教练员和队医了解和评估运动员踝关节结构和功能状况.Objective To analyze the imaging abnormal findings of ankle injuries in professional soccer player of males.Methods The thirty-two professional soccer players in local region soccer club had been selected as research objects from March 2014 to January 2015,and all were men.Average age was 22.03 ＋ 3.0 years old （19-33 years）;the average age was 8.6 ＋ 2.0 years old that began to engage in professional football training,and average time of engaged in football sports was 13 ±＋4 years（7-27 years）.X-ray examination was used VM DR （Philips Co.）,anteroposterior and lateral position of ankle joints.CT scan was used MSCT of 64 rows detector（Aquilion 64,TOSHIBA Co.）.After routine scan,raw data was transmitted to the workstation and then reconstructed to be axial,sagittal,coronal imaging.MR examination was used 1.5 T superconducting equipment system（Achieva Dual,Philips Co.） and with ankle joint special phased array coil.TSE sequence be used to scan routine axial T2-weighted imaging;coronal T1-weighted imaging;coronal PWI;and sagittal T2-weighted imaging with fat suppressed.The sagittal PWI scan was used with Isotropic with fat suppressed FFE sequence.Results The X-ray examination was finished for 28 person and 51 ankle joints.26 person and 52 ankle joints were completed CT scan and reconstructed imaging for all joints.MR examination was finished in 30 person and 51 ankle joints.On X-ray and CT display that the abnormal changes of the talus is most commonly found that the incidence of ＆quot;dolphin mouth＆quot; like protrusion at posterior edge was 35 ankles （rate of occurrence was 68.6%）,the triangle prominence at out edge was 45 ankles （rate of occurrence was 88.2%）.It also was found that 8 lateral malleolus have osteophytes,5 ankles have medial malleolus osteophytes and 12 ankles have loose bodies at posterior ankle.MRI showed that 30 ankles were the anterior talofibular ligaments injury and incidence was 58.82%,26 ankles were posterior talofibular ligaments injury （incidence was 51

关 键 词：磁共振成像 体层摄影术 X线计算机 踝关节 

分 类 号：R873[医药卫生—运动医学]