MR检查在踝关节不同体位下对周围韧带和肌腱损伤的诊断价值研究  

Study on the Diagnostic Value of MRI Examination for Periarticular Ligament and Tendon Injuries in Different Positions of the Ankle Joint

作　　者：周祺源[1] 杨俊霞[1] 詹浩辉[1] 程鹏[1] ZHOU Qiyuan;YANG Junxia;ZHAN Haohui;CHENG Peng(Medical Imaging Center,The Second Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471000,China)

机构地区：[1]河南科技大学第二附属医院医学影像中心,河南洛阳471000

出　　处：《临床研究》2024年第6期124-126,共3页Clinical Research

摘　　要：目的分析磁共振(MRI)检查在踝关节不同体位下对周围韧带和肌腱损伤的诊断价值。方法选择2021年1月至2023年7月河南科技大学第二附属医院收治的76例踝关节扭伤/骨折患者作为此次研究对象,纳入研究患者均接受MRI检查(分不同体位检查:自然体位、完全跖屈、完全背屈)。对比不同体位下踝骨内侧、外侧MRI T_(2)值;另外将MRI检查与手术结果进行对照,对其诊断结果及阳性征象检出率进行分析比较。结果自然体位、完全跖屈、完全背屈踝骨内外侧负重区、非负重区MRI T_(2)指对比差异无统计学差异(P>0.05);经手术发现阳性70例,阴性6例,自然体位MRI检查诊断阳性68例,阴性8例,完全跖屈MRI检查诊断阳性67例,阴性9例,完全背屈MRI检查诊断阳性65例,阴性11例。自然体位MRI检查诊断准确度、灵敏度及特异度分别为94.74%、95.71%、83.33%,完全跖屈MRI检查诊断准确度、灵敏度及特异度分别为90.79%、92.86%、66.67%;完全背屈MRI检查诊断准确度、灵敏度及特异度分别为90.79%、91.43%、83.33%,三种体位MRI诊断效能对比差异无统计学意义(P>0.05)。结论MRI能较准确的评估踝扭伤/骨折患者的踝关节稳定性,在踝关节3种体位下(自然体位、完全跖屈、完全背屈)均能较敏感的反映周围韧带和肌腱损伤情况。Objective To analyze the diagnostic value of magnetic resonance imaging(MRI)examination for periarticular ligament and tendon injuries in different positions of the ankle joint.Methods Seventy-six patients with ankle sprains/fractures treated at the Second Affiliated Hospital of Henan University of Science and Technology from January 2021 to July 2023 were selected as the subjects of this study.All patients underwent MRI examination in different positions(natural position,full dorsiflexion,full plantar flexion).The MRI T_(2) values of the medial and lateral aspects of the ankle joint in different positions were compared.Additionally,MRI results were compared with surgical findings to analyze the diagnostic results and the detection rate of positive signs.Results There was no significant difference in MRI T_(2) values of the weight-bearing and non-weight-bearing areas of the medial and lateral aspects of the ankle joint in the natural position,full dorsiflexion,and full plantar flexion(P>0.05).Surgical findings revealed 70 positive cases and 6 negative cases.The diagnostic accuracy,sensitivity,and specificity of MRI in the natural position were 94.74%,95.71%,and 83.33%,respectively;in full dorsiflexion,they were 90.79%,92.86%,and 66.67%,respectively;and in full plantar flexion,they were 90.79%,91.43%,and 83.33%,respectively.There was no statistically significant difference in the diagnostic efficiency of MRI in the three positions(P>0.05).Conclusion MRI can accurately evaluate the stability of the ankle joint in patients with ankle sprains/fractures.MRI in three positions(natural position,full dorsiflexion,full plantar flexion)can sensitively reflect periarticular ligament and tendon injuries,and combining these three positions can achieve the most accurate imaging diagnosis.

关 键 词：MRI检查 踝关节 韧带损伤 肌腱损伤 诊断效能 

分 类 号：R686[医药卫生—骨科学]