足痛患者足副舟骨的发生率及其解剖分型的多种影像学分析  

Imaging Analysis of the Incidence and Anatomical Classification of Scaphoid in Patients with Foot Pain

作　　者：孙莉薇[1] 王捷[1] 钟华[1] 段少银[1] 康江河[1] Sun Liwei;Wang Jie;Zhonghua;Duan Shaoyin;Kang Jianghe(Department of Imdging,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361004)

机构地区：[1]厦门大学附属中山医院影像科,福建厦门361004

出　　处：《现代医用影像学》2021年第12期2182-2186,共5页Modern Medical Imageology

摘　　要：背景:探讨痛性足副舟骨的影像学诊断价值,指导临床实施治疗,最大限度提高治疗效果。目的:分析足副舟骨的发生率、解剖变异分型及损伤后的影像学表现,提高对痛性足副舟骨的认识。方法:回顾性收集本院2017-2019年期间336例(男212例,女124例)因外伤后足部疼痛或持续慢性足部疼痛的患者,拍摄患足X线正斜位片,其中15例行CT检查,5例行MRI检查。统计足副舟骨的发生率和解剖变异分型,分析不同摄片位置足副舟骨的显示率及其多种影像学特征。结果与结论:足痛患者336例(男212例,女124例)中,发现副舟骨52例,发生率约为15.5%。在52例足副舟骨中分3型,Ⅰ型15例(28.8%),Ⅱ型32例(61.5%),Ⅲ型5例(9.7%)。足正位及内、外斜位X光片显示率分别约为85.7%、66.1%、100%,三组间两两比较有统计学意义(P<0.016)。CT、MRI均能显示副舟骨,CT三维成像展现足副舟骨与舟骨关系清楚,MRI可显示局部骨髓水肿和软组织病变。足副舟骨Ⅱ型最常见,足正位及外侧斜位片是足舟骨损伤的首选影像学检查,CT、MRI检查显示更全面。足副舟骨并不少见,分析其解剖与分型,可以提高诊断准确率,减少临床误诊与误治。Background:To explore the imaging diagnostic value of painful parascaphoid of foot,guide the clinical implementation of treatment,and maximize the therapeutic effect.Objective:To improve the understanding of painful scaphoid,the incidence of scaphoid,anatomic variation and imaging manifestations were analyzed.Methods:A retrospective study was conducted on 336 patients(212 males and 124 females)with foot pain or persistent chronic foot pain after trauma in our hospital from 2017 to 2019.Foot X-ray positive and oblique radiographs were taken,of which 15 underwent CT examination and 5 underwent MRI examination.The incidence of accessory scaphoid of foot and the classification of anatomical variation were counted,and the display rate of accessory scaphoid of foot and its various imaging characteristics were analyzed at different radiographic locations.Results and conclusion:Among 336 patients with foot pain(212 males and 124 females),52 cases of accessory scaphoid were found,with an incidence of about 15.5%.Among 52 cases of accessory scaphoid,there were 3 types,15 typeⅠ(28.8%),32 typeⅡ(61.5%)and 5 typeⅢ(9.7%).The X-ray display rates of foot orthotopic,medial and external oblique position were about 85.7%,66.1%and 100%,respectively.There was a statistical significance in pairwise comparison among the three groups(P<0.016).CT and MRI can show the accessory scaphoid,CT three-dimensional imaging shows a clear relationship between the accessory scaphoid and the scaphoid,and MRI can show local bone marrow edema and soft tissue lesions.Anteroposterior and lateral oblique radiographs of the foot are the preferred imaging examinations for scaphoid injury,and CT and MRI examinations show more comprehensive findings.Foot accessory scaphoid is not uncommon.Analysis of its anatomy and classification can improve the accuracy of diagnosis and reduce clinical misdiagnosis and mistreatment.

关 键 词：足副舟骨 X线片 分型 CT三维成像 磁共振成像 

分 类 号：R658.3[医药卫生—外科学]