隐匿性Lisfranc韧带损伤的MRI表现  

MRI of the occult Lisfranc ligament injury

作　　者：冯志远[1] 梁文洲 白荣杰 曹宇鹏 藏金生 钱占华 詹惠荔 王崧铭 FENG Zhiyuan;LIANG Wenzhou;BAI Rongjie;CAO Yupeng;ZANG Jinsheng;QIAN Zhanhua;ZHAN Huili;WANG Songming(Department of Radiology,Beijing Huilongguan Hospital,Beijing 100096,China;Department of Radiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]北京回龙观医院放射科,北京100096 [2]首都医科大学附属北京积水潭医院放射科,北京100035

出　　处：《实用放射学杂志》2023年第11期1823-1827,共5页Journal of Practical Radiology

基　　金：国家自然科学基金面上项目(82171921,81771809)。

摘　　要：目的探讨Lisfranc韧带正常解剖及损伤的MRI技术及影像学表现,为隐匿性Lisfranc韧带损伤的诊断与治疗提供影像学依据。方法回顾性分析20例健康志愿者(40侧足)和32例经手术证实Lisfranc韧带损伤患者的影像学资料。所有被试均行Lisfranc关节的斜冠状位(短轴位)、矢状位和斜轴位(长轴位)MRI T1WI和质子密度脂肪抑制(PD-FS)序列扫描。分析观察正常Lisfranc韧带形态结构以及韧带损伤的影像学表现,并将Lisfranc韧带损伤的MRI表现与手术结果进行对照分析,由双盲法分析确认。结果Lisfranc韧带MRI T1WI序列及PD-FS序列呈细条状低信号。损伤的韧带MRI表现为T1WI序列呈略低信号改变,纤维结构增粗或不连续,PD-FS序列韧带信号增高,可见水样高信号。矢状位可清晰显示Lisfranc关节和足纵弓对位情况,Lisfranc关节背侧韧带和跖侧韧带显示较好,而Lisfranc韧带显示较差。斜冠状位(短轴位)可清晰显示足横弓及Lisfranc韧带横切面。斜轴位(长轴位)可清晰显示Lisfranc关节及其周围的韧带和肌腱,尤其是Lisfranc韧带起止点及其走行全长。结论高分辨3.0T MRI技术可清晰显示Lisfranc韧带的精细解剖结构和损伤的影像学表现,尤其对隐匿性Lisfranc韧带损伤的早期诊断、精准治疗具有重要价值。Objective To explore MRI technique and characteristics of normal anatomy and injuries of Lisfranc ligament,and provide imaging basis for the diagnosis and treatment of the occult Lisfranc ligament injury.Methods A total of 20 healthy volunteers(40 sides)and 32 patients with the occult Lisfranc ligament injury were analyzed.All volunteers and patients underwent scans of oblique coronal position(short axis),sagittal and oblique axial position(long axis)including T1WI and proton density-fat suppression(PD-FS)sequences of MRI.Then the MRI characteristics of Lisfranc ligament of healthy volunteers and patients with Lisfranc ligament injuries were studied and compared with thesurgical results and confirmed by double-blind method.Results MRI T1WI and PD-FS sequence of Lisfranc ligament showed thin strip low signal intensity in healthy volunteers.The MRI of the injured ligament showed slightly low signal change on T1WI sequence,thickening or discontinuity of fiber structure,interruption of ligament signal in PD-FS sequence.The alignment of Lisfranc joint and longitudinal arch of foot could be clearly displayed in sagittal position.The dorsal ligament and metatarsal ligament of Lisfranc joint were well displayed,while the Lisfranc ligament was poorly displayed.The oblique coronal position(short axis)clearly showed the transverse arch of the foot and the cross-section of the Lisfranc ligament.The oblique axial position(long axis)clearly showed the Lisfranc joint and its surrounding ligaments and tendons,especially the full length of the Lisfranc ligament and its enthesis.Conclusion High-resolution 3.0T MRI can clearly show MR imaging features of the normal anatomy and occult injuries of the Lisfranc ligament,and it is especially of great values for the early diagnosis and accurate the occulttreatment of Lisfranc ligament injury.

关 键 词：Lisfranc韧带 解剖 损伤 磁共振成像 

分 类 号：R686[医药卫生—骨科学] R445.2[医药卫生—外科学]