Steinborn M, Heuck A, Maier M, Schnarkowski P, Scheidler J, Reiser M
Institut für Radiologische Diagnostik, Ludwig-Maximilians-Universität München.
Rofo. 1999 Jan;170(1):41-6. doi: 10.1055/s-2007-1011005.
The purpose of this study was to determine the type and frequency of characteristic bone and soft tissue changes on MRI of patients with a clinical diagnosis of plantar fasciitis.
28 patients with a clinical diagnosis of plantar fasciitis underwent MR imaging. Besides T1- and T2-weighted sequences, short-tau-inversion-recovery sequences were used routinely. In 27 patients T1-weighted images after intravenous contrast injection were acquired additionally. As a control group the images of 15 patients without clinical signs for plantar fasciitis were evaluated.
In 25 of 28 cases (89%) the clinical diagnosis of plantar fasciitis was established by MR imaging. The most common finding was a peritendinous edema at the calcaneal insertion site which was found in all 25 patients. In 19 of 25 cases (76%) a bone marrow edema of the calcaneus was present. In 14 of 25 cases (56%) an intratendinous signal intensity increase of the plantar fascia could be observed which showed contrast enhancement in 12 cases. Compared to the control group (mean thickness 3.3 mm) the plantar fascia showed significant thickening in the 25 MR positive patients (mean thickness 6.72 mm).
Besides thickening of the plantar fascia and intratendinous signal intensity increase with contrast enhancement to some extent, bone marrow edema of the calcaneus and peritendinous edema close to the plantar fascia are characteristic signs of plantar fasciitis on MRI. Both signs can reliably be seen on STIR sequences only.
本研究的目的是确定临床诊断为足底筋膜炎患者的MRI上特征性骨与软组织改变的类型及频率。
28例临床诊断为足底筋膜炎的患者接受了MR成像检查。除T1加权和T2加权序列外，常规使用短反转恢复序列。27例患者还额外采集了静脉注射对比剂后的T1加权图像。作为对照组，评估了15例无足底筋膜炎临床体征患者的图像。
28例中的25例（89%）通过MR成像确立了足底筋膜炎的临床诊断。最常见的表现是跟骨附着部位的腱周水肿，25例患者均有此表现。25例中的19例（76%）存在跟骨骨髓水肿。25例中的14例（56%）可观察到足底筋膜内信号强度增加，其中12例有对比增强。与对照组（平均厚度3.3mm）相比，25例MR检查阳性的患者足底筋膜明显增厚（平均厚度6.72mm）。
除了足底筋膜增厚以及在一定程度上腱内信号强度增加并伴有对比增强外，跟骨骨髓水肿和足底筋膜附近的腱周水肿是足底筋膜炎在MRI上的特征性表现。这两种表现仅在短反转恢复序列上能可靠地观察到。
