Faculdade de Medicina da Universidade do Porto, Hospital São João, Alameda Professor Hernâni Monteiro, 4200-451 Porto, Portugal.
AJR Am J Roentgenol. 2010 Dec;195(6):W447-55. doi: 10.2214/AJR.10.4674.
The aim of our study was to clarify the ligamentous anatomy of the Lisfranc joint complex and show the diagnostic capability of MRI in the assessment of the Lisfranc joint complex with detailed anatomic correlation in cadavers.
Ten fresh cadaveric feet were studied with high-spatial-resolution MRI before and after the intraarticular injection of a gadopentetate dimeglumine solution. MR images were evaluated by two readers in consensus, with emphasis on the visibility of the ligamentous structures and their appearance. Readers also measured the dimensions (length, width, and thickness) of the Lisfranc ligament and of the first plantar tarsometatarsal ligament, or plantar Lisfranc ligament. For anatomic analysis, nine cadaveric specimens were sectioned in 3-mm-thick slices in the same planes used during MRI. One additional foot specimen was used for dissection.
In all 10 cadaveric specimens we were able to identify and characterize with MRI the different ligamentous elements that contribute to the overall stability of the Lisfranc joint complex.
By clearly defining the normal ligaments that contribute to the stability of the Lisfranc joint, MRI allows a more precise and correct diagnosis of the origin of the Lisfranc joint instability, perhaps permitting a more specific surgical management. MRI also allows a better understanding of the normal imaging anatomy of the different ligamentous components of the Lisfranc joint, mainly of the Lisfranc and plantar Lisfranc ligaments.
我们研究的目的是阐明跖跗关节复合体的韧带解剖结构，并展示 MRI 在评估跖跗关节复合体方面的诊断能力，同时与详细的解剖相关性进行尸体研究。
在向关节内注射钆喷替酸二葡甲胺溶液前后，我们对 10 具新鲜尸体足进行了高空间分辨率 MRI 研究。两位读者通过共识评估 MR 图像，重点关注韧带结构的可见性及其外观。读者还测量了跖跗韧带和第一跖骨底跗跖韧带（足底跖跗韧带）的尺寸（长度、宽度和厚度）。为了进行解剖学分析，我们在与 MRI 相同的平面上将 9 具尸体标本切成 3 毫米厚的切片。另外一只脚标本用于解剖。
在所有 10 具尸体标本中，我们都能够通过 MRI 识别和描述有助于维持跖跗关节复合体整体稳定性的不同韧带结构。
通过明确界定有助于维持跖跗关节稳定性的正常韧带，MRI 可以更精确和正确地诊断跖跗关节不稳定的起源，也许可以进行更具针对性的手术治疗。MRI 还可以更好地了解跖跗关节不同韧带成分的正常影像学解剖结构，主要是跖跗韧带和足底跖跗韧带。
