NHS, Arrowe Park Hospital, Wirral University Hospital, Upton, Wirral, UK CH49 5PE.
Skeletal Radiol. 2013 Jul;42(7):969-73. doi: 10.1007/s00256-013-1618-3. Epub 2013 May 2.
The authors aim to present the common MRI appearances of surgically proven spring ligament tears as minimal radiological literature exists regarding injury to this increasingly important structure.
Our retrospective review identified a treatment group comprising 13 cases of surgically proven spring ligament injury and a 96-patient comparison group. All patients underwent standard musculoskeletal MRI sequences of the foot and ankle. Images were reviewed by a registrar-grade orthopedic surgeon and a consultant musculoskeletal radiologist for abnormalities of the spring ligament complex.
MRI findings in relation to surgically proven injury of the superior-medial portion of the spring ligament included proximal thickening >5 mm in 92 % and distal thinning <2 mm in 85 % of proven injures to the spring ligament complex. Common abnormalities of the medio-plantar portion comprised ligament thickening >7 mm in 31 % and intra-substance signal heterogenicity demonstrated in 38 % of cases.
The complex orientation of the medio-plantar ligament makes its evaluation unreliable due to the difficulty obtaining diagnostic quality imaging and our inability to correlate MRI findings in this portion of the ligament with surgically proven injury. However, MRI abnormalities of the superior-medial ligament are consistent, reproducible, and correlate with surgical pathology. As our incomplete understanding of the flexible flatfoot deformity evolves, our ability to recognize injury to the spring ligament may encourage novel surgical treatments looking to incorporate its repair or reconstruction into deformity correction.
目前关于该结构（即日益重要的距腓前韧带）损伤的相关放射学文献较少，作者旨在展示经手术证实的距腓前韧带撕裂的常见 MRI 表现。
我们进行了一项回顾性研究，在接受手术证实的距腓前韧带损伤治疗的 13 例患者中识别出治疗组，并在 96 例患者中识别出对照组。所有患者均接受了足部和踝关节的标准肌肉骨骼 MRI 序列检查。由一名注册等级的骨科医生和一名顾问级的肌肉骨骼放射科医生对距腓前韧带复合体的异常情况进行图像审查。
与距腓前韧带中上段手术证实损伤相关的 MRI 发现包括：92%的患者距腓前韧带复合体的近端增厚>5mm，85%的患者距腓前韧带复合体的远端变薄<2mm。中足底部分常见的异常包括：31%的患者韧带增厚>7mm，38%的患者韧带内信号不均匀。
由于难以获得诊断质量的图像，并且我们无法将该韧带中这部分的 MRI 发现与手术证实的损伤相关联，因此中足底韧带复杂的方向使其评估不可靠。然而，距腓前韧带中上段的 MRI 异常具有一致性、可重复性，并与手术病理相关。随着我们对弹性平足畸形认识的不断发展，我们识别距腓前韧带损伤的能力可能会鼓励采用新的手术治疗方法，以期将其修复或重建纳入畸形矫正。
