Oh Chang-Seok, Won Hyung-Sun, Hur Mi-Sun, Chung In-Hyuk, Kim Sungjun, Suh Jin-Suck, Sung Ki-Sun
Department of Anatomy, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, 440-746, Korea.
AJR Am J Roentgenol. 2006 Apr;186(4):943-7. doi: 10.2214/AJR.04.1784.
The purpose of this study was to identify the intermalleolar ligament morphologically and to correlate its shape with MR images.
Seventy-seven ankles were used in this study. After the intermalleolar ligament had been located in the posterior ankle space, its medial and lateral attaching sites were identified, and its length, width, and thickness were measured. MRI was performed on 26 ankles before they were dissected (20 specimens) or serially sectioned (six specimens). The serial sections were taken at a thickness of 2 mm in the sagittal and horizontal directions.
The intermalleolar ligament was observed in 81.8% of the specimens and was composed of more than two bundles of fibers in all cases. The medial arising sites of the ligament were diverse (e.g., from the medial malleolus to the floor of the fibrous tunnel of the flexor hallucis longus). The ligament narrowed laterally and attached with the posterior talofibular ligament to the medial fossa of the lateral malleolus. Their morphologic shapes were also diverse, depending on their medial arising sites, the number of the composing fiber bundles, and the degree of bundle compactness. The intermalleolar ligament appeared as a thick string or as more than two fine parallel stripes on coronal MR images and as a linear structure on axial images. On sagittal images, the ligament appeared as scattered dots in the medial part and as a thin flat or nodular structure in the lateral part.
The intermalleolar ligament seemed to be an almost invariably present anatomic entity with diverse morphologic features on MR images.
本研究旨在从形态学上识别踝间韧带，并将其形状与磁共振成像（MR）图像相关联。
本研究使用了77个踝关节。在确定踝间韧带位于踝关节后方间隙后，识别其内侧和外侧附着点，并测量其长度、宽度和厚度。对26个踝关节在解剖（20个标本）或连续切片（6个标本）前进行了MRI检查。矢状面和水平面的连续切片厚度为2毫米。
在81.8%的标本中观察到踝间韧带，所有病例中均由两束以上纤维组成。韧带的内侧起始部位各不相同（例如，从内踝到拇长屈肌纤维隧道底部）。韧带在外侧变窄，并与后距腓韧带一起附着于外踝的内侧窝。其形态也各不相同，取决于其内侧起始部位、组成纤维束的数量以及束的紧密程度。在冠状面MR图像上，踝间韧带表现为一条粗线或两条以上细的平行条纹，在轴位图像上表现为线性结构。在矢状面上，韧带在内侧部分表现为散在的点，在外侧部分表现为薄的扁平或结节状结构。
踝间韧带似乎是一种几乎总是存在的解剖结构，在MR图像上具有多种形态特征。
