伴有踝关节外侧副韧带损伤的慢性外侧踝关节不稳患者距骨软骨的T_2-mapping评估  

T_2-mapping evaluation of talar cartilage for chronic lateral ankle instability (LAI) with lateral ankle ligaments tear

作　　者：陶虹月[1] 胡忆文 乔洋[1] 马魁[1] 华英汇[1] 陈爽[1] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040

出　　处：《放射学实践》2017年第6期625-629,共5页Radiologic Practice

基　　金：上海市体育局2015年科技综合计划(Z005);上海市自然科学基金(16ZR1404600)资助项目

摘　　要：目的:应用T_2-mapping定量评估伴有踝关节外侧副韧带(LAL)损伤的慢性外侧踝关节不稳(LAI)患者的距骨软骨退变情况。方法:搜集19例来本院就诊的伴有LAL损伤的慢性LAI患者和21例健康受试者。对这些研究对象进行T_2-mapping扫描和美国足踝外科评分系统评分。将距骨滑车软骨分为内侧前部(MA)、内侧中部(MC)、内侧后部(MP)、外侧前部(LA)、外侧中部(LC)、外侧后部(LP)6个部分。测量并计算每个软骨区域的平均T_2值,总距骨软骨(TTC)的T_2值由6块软骨的平均T_2值得到,计算慢性LAI组每个软骨区域T_2值相对于对照组相应软骨区域T_2值的增加率。应用独立样本t检验比较慢性LAI组与对照组各软骨区域T_2值的差异,应用Pearson相关分析研究慢性LAI组T_2值与美国足踝外科评分系统(AOFAS)评分的相关性。结果:慢性LAI组的距骨MA、MC、MP和TTC软骨区域的T_2值高于对照组(分别为P<0.001,P=0.026,P=0.002,P<0.001),其中MA软骨区域T_2值的增加率最为显著(18.65%)。慢性LAI患者的AOFAS评分为69.32±7.22,MA软骨区域的T_2值与AOFAS评分呈负相关(r=-0.525,P<0.05),其余软骨区域T_2值与AOFAS评分无明显相关性(P>0.05)。结论:伴有LAL损伤的慢性LAI患者的距骨软骨发生了退变,主要累及距骨内侧软骨面,MA软骨区域最为明显,MA是影响患者临床症状和预后的主要软骨区域。Objective： To quantitatively evaluate the talar cartilage degeneration of chronic lateral ankle instability with lateral ligament tear using T2 mapping. Methods： Nineteen patients with chronic lateral ankle instability （chronic LAI group） and 21 healthy subjects （control group） were recruited in this study. All participants underwent T2-mapping scan and all patients completed American Orthopaedic Foot and Ankle Society scoring. The total talar trochlear cartilage was divided into six compartments：medial anterior （MA） ,medial center （MC） ,medial posterior （MP） ,lateral anterior （IRA） ,lat eral center （LC） ,and lateral posterior （LP）. The mean T~ value and its increasing rate of each compartment was measured. The Student＇s t--test was used to compare the difference of T2 values between the two groups;Pearson＇s correlation coeffi cient was used to analyze the correlation between T2 values and AOFAS scores in chronic LAI group. Results：The T2 values of MA,MC,MP and TTC in chronic LAI group were higher than that of control group （P^0. 001,P 0. 026,P 0. 002, P%0. 001）. The most significant increasing rate of T2 value was found at MA （18.65%）. AOFAS score of chronic LAI group was 69.32±7. 22. The T2 value of MA in chronic LAI group was negatively correlated with AOFAS score （P〈 0.05）, while no other correlation of T2 values of the rest cartilage compartments was found （P〉0.05）. Conclusion：Chronic LAI with lateral ankle ligament tear may result in extensive and severe cartilage degeneration compared to the control group, especially in the medial compartment. Moreover, MA is the most severely affected compartment by cartilage degener ation. MA can be the main cartilage compartment that may affect the patient＇s clinical symptoms and prognosis.

关 键 词：踝损伤 外侧韧带 踝 软骨疾病 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.73[医药卫生—诊断学]