踝三角韧带不同构成部分急性损伤的MRI诊断  

MRI Diagnosis of Acute Injury of Different Part of Deltoid Ligament

作　　者：黄耀渠[1] 樊长姝[2] 秦红卫[1] 伍琼慧[1] 赵晓梅[1] 

机构地区：[1]广东省佛山市中医院MRI室,528000 [2]北京世纪坛医院放射科,100038

出　　处：《临床放射学杂志》2016年第6期919-923,共5页Journal of Clinical Radiology

基　　金：广东省科技计划基金项目(编号:2014A020221096)

摘　　要：目的分析踝三角韧带不同构成部分急性损伤的MRI表现及诊断价值,以提高其诊断水平。方法回顾性分析经手术证实的27例踝三角韧带急性损伤患者的MRI资料,同时选择25例无踝关节症状志愿者为对照组。三角韧带分为胫舟-胫跟韧带、胫距前韧带和胫距后韧带3个部分进行评估。结果与手术比较,MRI诊断胫舟-胫跟韧带急性损伤的Kappa系数为0.71(P<0.01),韧带迂曲、信号增高和形态异常3个征象的诊断准确性分别为73.1%、92.3%和92.3%。MRI诊断胫距前韧带急性损伤的Kappa系数为0.46(P<0.01),信号增高和形态异常征象的诊断准确性分别为71.2%和73.1%。MRI诊断胫距后韧带急性损伤的Kappa系数为0.66(P<0.01),韧带结构扭曲和形态异常的诊断准确性分别为84.6%和90.4%。结论 MRI能显示三角韧带各构成部分正常解剖及急性损伤的特征,特别是对胫舟-胫跟韧带及胫距后韧带损伤有较高的诊断价值,但对胫距前韧带的诊断价值相对较低。Objective To analyze the MRI findings and diagnostic value of different parts of an acute injury of the deltoid ligament in order to improve the diagnostic accuracy.Methods MRI data of 27 patients with acute injury of deltoid ligament confirmed by operation were retrospectively analyzed,and twenty-five volunteers without symptoms of ankle joint were selected as the control group.The deltoid ligament is divided into tibionavicular-tibiocalcaneal ligament（TN-TCL）,anterior tibiotalar ligament（a TTL） and posterior tibiotalar ligament（p TTL） three parts to evaluate.Results Compared with surgery,the kappa coefficient of MRI diagnosing TN-TCL acute injury was 0.71（P 〈0.01）; the accuracy of MRI sign of ligament tortuosity,increased signal and abnormal morphology in diagnosing acute injury were 73.1%,92.3% and 92.3% respectively.For a TTL,the kappa coefficient of MRI diagnosing acute injury was 0.46（P 〈0.01）; the accuracy of ligament signal increase and abnormal morphology in diagnosis were 71.2% and 73.1%.The kappa coefficient of MRI diagnosing p TTL acute injury was 0.66（P 〈0.01）; the accuracy of the structural distortion and abnormal morphology of the ligaments in diagnosing acute injury were 84.6% and 90.4% respectively.Conclusion MRI can display the normal anatomy and characteristics of acute injury of each part of the deltoid ligament.MRI is especially valuable for diagnosing injury of TN-TCL and p TTL.However,for a TTL injury,the diagnostic value of MRI is relatively low.

关 键 词：三角韧带 踝关节 损伤 磁共振成像 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]