踝关节外侧副韧带损伤程度与X线应力位下测量数值相关性分析  

The relationship between ankle joint lateral ligament damage degree and stress ankle radiographs measurement

作　　者：陈思[1] 万鑫[2] 万业达[1] CHEN Si;WAN Xin;WAN Ye-da(First Department of Radiology,Tianjin Hospital,Tianjin 300211,China;Department of Physical Diagnosis,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医院放射一科,天津300211 [2]天津医院物理诊断科,天津300211

出　　处：《天津医科大学学报》2022年第2期173-176,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨踝关节外侧韧带损伤程度(3D核磁共振表现)与X线踝关节应力位测量数值之间的关系。方法:选择2019年6月—2020年12月治疗的有踝关节韧带损伤病史126例患者作为研究分析对象,对所选患者测定X线踝关节应力位上距骨倾斜角度和距骨前移距离;对踝关节外侧副韧带(主要是腓距前韧带和腓跟韧带)损伤程度在MRI上进行评估。统计分析踝关节外侧副韧带与X线应力位测量数值(距骨倾斜角度和距骨前移距离)之间的相关性。结果:完整的腓距前韧带内翻应力位距骨倾斜角为(3.97±1.76)°,前抽屉位距骨前移距离为(3.86±1.18)mm;完整的腓跟韧带内翻应力位距骨倾斜角为(5.64±2.13)°,前抽屉位距骨前移距离为(4.37±1.54)mm。随着腓距前韧带和腓跟韧带损伤程度增加,内翻位距骨倾斜角增大,前抽屉位距骨前移距离增加,差异具有统计学意义(P<0.05)。踝关节外侧韧带(腓距前韧带与腓跟韧带)损伤程度与X线踝关节应力位下距骨倾斜角、距骨前移距离之间呈正相关(r=0.748,P<0.001;r=0.425;P=0.002;r=0.487;P<0.001;r=0.402,P=0.004)。结论:腓距前韧带和腓跟韧带损伤程度与内翻位距骨倾斜角和前抽屉位距骨前移距离之间(特别是内翻位距骨倾斜角)呈正相关,可以作为临床诊断的重要依据。Objective:To investigate the relationship between ankle joint lateral ligament damage degree(3D-PDWI-SPACE in MR)and stress ankle radiograph measurement.Methods:A total of 126 consecutive patients with a history of ankle ligament injury treated from June 2019 to December 2020 were recruited in this study.Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs.The distributions of the lateral ligaments of ankle(mainly anterior talofibular,calcaneofibular ligament)morphologies on MRI were evaluated.The correlation between the lateral collateral ligament morphologies of ankle and stress radiographs measurement(talus inclination angle and talus forward displacement distance)was examined.Results:The tibiotalar tilt angle of intact anterior talofibular was(3.97±1.76)°,and the anterior translation of talus was(3.86±1.18)mm.The tibiotalar tilt angle of intact calcaneofibular was(5.64±2.13)°,and the anterior translation of talus was(4.37±1.54)mm.With the acceleration of injury degree of anterior peroneal ligament and calcaneal ligament,the tibiotalar tilt angle and anterior translation of talus increased,the difference was statistically significant(P<0.05).There was a positive correlation between the degree of injury of anterior talofibular and calcaneofibular with the tibiotalar tilt angle and anterior translation of talus(r=0.748,P<0.001;r=0.425,P=0.002;r=0.487,P<0.001;r=0.402,P=0.004,respectively).Conclusion:There is a positive correlation between the degree of injury of anterior talofibular and calcaneofibular with the tibiotalar tilt angle and anterior translation of talus(especially the tibiotalar tilt angle),which could be used as a critical guideline for future clinical diagnosis.

关 键 词：外侧副韧带 踝关节 应力位 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]