MRI 检查在慢性外侧踝关节韧带损伤中的准确性：与手术结果的比较。
Accuracy of MRI findings in chronic lateral ankle ligament injury: comparison with surgical findings.
机构信息
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
出版信息
Clin Radiol. 2012 Apr;67(4):313-8. doi: 10.1016/j.crad.2011.08.025. Epub 2011 Nov 9.
AIM
To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings.
MATERIALS AND METHODS
Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings.
RESULTS
The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively.
CONCLUSIONS
The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p < 0.001).
目的
评估磁共振成像（MRI）在慢性外侧踝关节韧带损伤中的准确性，并与手术结果进行比较。
材料与方法
48 例（25 名男性，23 名女性，平均年龄 36 岁）临床疑似慢性踝关节韧带损伤患者接受 MRI 研究和手术。所有患者均进行矢状位、冠状位、轴位 T1 加权、自旋回波、质子密度和 T2 加权、快速自旋回波、带脂肪饱和的图像。两名接受过 fellowship培训的学术肌肉骨骼放射科医生对 MRI 检查进行了共识评估，评估了外侧踝关节韧带，包括距腓前韧带（ATFL）和跟腓韧带（CFL），不参考临床信息。然后将 MRI 研究结果与手术结果进行比较。
结果
ATFL 损伤的 MRI 发现显示完全撕裂的检测灵敏度为 75%，特异性为 86%。部分撕裂的检测灵敏度为 75%，特异性为 78%。扭伤的检测灵敏度为 44%，特异性为 88%。关于 CFL 损伤的 MRI 发现，完全撕裂的检测灵敏度为 50%，特异性为 98%。部分撕裂的检测灵敏度为 83%，特异性为 93%。扭伤的检测灵敏度为 100%，特异性为 90%。对于 ATFL，无损伤、扭伤、部分撕裂和完全撕裂的检测准确率分别为 88%、58%、77%和 85%，对于 CFL，无损伤、扭伤、部分撕裂和完全撕裂的检测准确率分别为 90%、90%、92%和 96%。
结论
MRI 对 ATFL 完全撕裂的诊断比 CFL 完全撕裂的诊断更敏感。CFL 损伤的 MRI 表现具有诊断特异性，但不敏感。然而，只有正常表现和完全撕裂在 ATFL 和 CFL 之间具有统计学意义（p<0.001）。
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