足副舟骨与胫后肌腱MRI表现的观察  

MRI findings of foot accessory navicular bone and posterior tibialis tendon in the foot

作　　者：刘冬雪 朴荣日[1] 刘松竹[1] 修超[1] LIU Dong-xue;PU Rong-ri;LIUSong-zhu;XIU Chao(Department of Radiology,Affiliated Hospital,Beihua University,Jilin,Jilin 132001,China)

机构地区：[1]北华大学附属医院放射科,吉林吉林132001

出　　处：《中国矫形外科杂志》2025年第4期377-380,共4页Orthopedic Journal of China

基　　金：吉林省卫生健康科技能力提升项目(编号:2022LC067)。

摘　　要：[目的]应用胫骨后肌腱(posterior tibial tendon,PTT)厚度指标从量化角度验证副舟骨(accessory navicular bone,AN)对早期胫骨后肌腱功能障碍(posterior tibial tendon dysfunction,PTTD)中PTT损伤程度的影响。[方法]2019年1月—2022年8月本院116例对PTT行MRI检查患者纳入本研究。将足内侧疼痛且MRI显示PTT损伤或鞘旁积液者定义为异常组;将无症状且MRI正常者定义为正常组。再另将两组按AN类型不同定义4个亚组,既无AN组、Ⅰ型AN组、Ⅱ型AN组、Ⅲ型AN组,比较两组测量结果,以是否异常与PTT厚度行ROC分析。[结果]正常组内各亚组PTT厚度无显著变化(P>0.05);异常组内Ⅱ型AN组PTT厚度显著增大(P<0.05),与正常组比较,异常组Ⅱ型AN亚组中PTT厚度[(4.1±1.2)mm vs(5.5±0.6)mm,P<0.001]显著增大,而其他各亚组两组间PTT厚度的差异均无统计学意义(P>0.05)。Ⅱ型AN亚组PTT横截面短径厚度判断是否异常ROC曲线,最佳截点是PTT厚度为4.7 mm时,敏感度为87.5%,特异度为85.7%,AUC为0.875。[结论]在PTTD中,Ⅱ型AN的存在可导致PTT厚度增加,加重其损伤程度。[Objective]To verify the impact of accessory navicular bone of foot(AN)on posterior tibialis tendon dysfunction(PTTD)byquantitative measurement of posterior tibialis tendon(PTT)thickness with MRI.[Methods]From January 2019 to August 2022,116 patients who received MRI examination of PTT in our hospital were included in this study.The patients with medial foot pain and MRI presentation of PTT injury or effusion around the tendon insertion were defined as the abnormal group,while those with no symptoms and normalMRI were defined as normal group.In addition,the two groups were further defined into 4 subgroups according to different AN types,including non AN group,type Ⅰ AN group,type Ⅱ AN group and type Ⅲ AN group.The measurement results of the two groups were compared,and ROC analysis was performed according to whether abnormality and PTT thickness.[Results]There was no significant change inPTT thickness of all subgroups in normal group(P>0.05).PTT thickness of type Ⅱ AN subgroup in abnormal group was significantly increased(P<0.05).Compared with the normal group,the type Ⅱ AN subgroup in abnormal group had significantly greater PTT thickness of[(4.1±1.2)mm vs(5.5±0.6)mm,P<0.001],despite of the fact that no significant difference in PTT thickness between the two groups in othersubgroups was noted(P>0.05).As results of ROC analysis PTT thickness of type Ⅱ AN subgroup predicting whether abnormality,the bestcut-off point was of 4.7 mm,sensitivity of 87.5%,specificity of 85.7%,with area under curve(AUC)of 0.875.[Conclusion]In PTTD,thepresence of type II AN can increase the thickness of PTT and aggravate the lesion.

关 键 词：副舟骨 胫骨后肌腱 胫骨后肌腱功能障碍 

分 类 号：R687[医药卫生—骨科学]