De Smet A A, Fisher D R, Burnstein M I, Graf B K, Lange R H
Department of Radiology, University of Wisconsin Clinical Science Center, Madison 53792.
AJR Am J Roentgenol. 1990 Mar;154(3):555-8. doi: 10.2214/ajr.154.3.2106221.
Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Clinical management of these lesions is based on whether or not the fragments are attached. We studied the value of MR imaging in determining the stability of the osteochondral fragments. In 13 of 14 patients who had had correlative surgery, we accurately predicted the presence and extent of attachment of the fragment to the talus by performing preoperative MR imaging. The other patient had a false-positive diagnosis of a chondral fragment. All seven partially attached fragments had an irregular high-signal zone on T2-weighted images at the fragment/talar interface. The four unattached fragments had a complete ring of fluid surrounding the lesion. On the basis of these findings, we think MR of the ankle can be used to assess accurately talar osteochondral lesion stability and aid in clinical decision making.
距骨骨软骨损伤（剥脱性骨软骨炎）是常见的关节损伤，通常源于创伤。这些损伤的临床处理取决于碎片是否附着。我们研究了磁共振成像（MR成像）在确定骨软骨碎片稳定性方面的价值。在14例接受相关手术的患者中，有13例通过术前MR成像，我们准确预测了碎片与距骨的附着情况及范围。另1例患者对软骨碎片的诊断为假阳性。所有7个部分附着的碎片在T2加权图像上，其碎片/距骨界面处均有不规则高信号区。4个未附着的碎片在病变周围有完整的液体环。基于这些发现，我们认为踝关节的MR成像可用于准确评估距骨骨软骨损伤的稳定性，并有助于临床决策。
