Yao L, Gentili A, Cracchiolo A
Department of Radiology, MRI, Georgetown University Medical Center, Washington, DC 20007-2197, USA.
Skeletal Radiol. 1999 May;28(5):245-50. doi: 10.1007/s002560050510.
Spring ligament insufficiency is associated with chronic posterior tibial tendon dysfunction, and may constitute an indication for surgical repair or reconstruction. This study examines the accuracy of MRI for the diagnosis of insufficiency of the spring ligament.
Two experienced musculoskeletal radiologists independently scored the MRI findings in 13 cases of surgically proven spring ligament insufficiency and in 18 control subjects, using a standardized scoring system.
Insufficiency of the spring ligament was associated with increased signal heterogeneity on short TE spin echo images, and an increase in the thickness of the medial portion of the ligament. The sensitivity of MRI for the diagnosis of spring ligament insufficiency was 54-77%, while the specificity was 100%. MRI assessment of the plantar portion of the spring ligament was unreliable (kappa=0.33), but the assessment of global ligament integrity was substantially reproducible (kappa=0.76).
The medial portion of the spring ligament can be reliably assessed on routine MRI. The findings of spring ligament insufficiency on MRI are only moderately sensitive but highly specific.
弹簧韧带功能不全与慢性胫后肌腱功能障碍相关，可能构成手术修复或重建的指征。本研究探讨磁共振成像（MRI）诊断弹簧韧带功能不全的准确性。
两名经验丰富的肌肉骨骼放射科医生使用标准化评分系统，对13例经手术证实的弹簧韧带功能不全患者及18名对照者的MRI检查结果进行独立评分。
弹簧韧带功能不全与短TE自旋回波图像上信号不均匀性增加以及韧带内侧部分厚度增加有关。MRI诊断弹簧韧带功能不全的敏感性为54% - 77%，特异性为100%。MRI对弹簧韧带足底部分的评估不可靠（kappa值 = 0.33），但对韧带整体完整性的评估具有高度可重复性（kappa值 = 0.76）。
在常规MRI上可对弹簧韧带内侧部分进行可靠评估。MRI诊断弹簧韧带功能不全的结果仅具有中等敏感性，但特异性高。
