Nogueira Ibevan A, Frère Annie F, Silva Alessandro P, Scardovelli Terigi A, Boschi Silvia Rms, Oliveira Heverton C
Núcleo de Pesquisas Tecnológicas, Universidade de Mogi das Cruzes, Mogi das Cruzes, São Paulo, Brazil.
Biomed Eng Online. 2014 Dec 16;13:168. doi: 10.1186/1475-925X-13-168.
Magnetic resonance (MR) techniques used to detect lesions of the ligament complex for articulation of the ankle lack the desired accuracy for the study of the calcaneofibular ligament (CFL). The lack of sensitivity of the conventional techniques is due to variations in the dimensions of the CFL. The best results are obtained when the image plane is oriented parallel to the ligament. This study aims to develop a model that addresses the width, length and angle parameters of the CFL and the orientation of the MR image plane, and thus determine a technique in the oblique transversal plane with the foot in anatomical flexion, that is adequate for the majority of patients.
To determine this orientation and adapt it to the majority of people, images of the articulation of the ankle in the 3D isotropic, volumetric, sagittal plane of 100 volunteers were taken using the MR technique. None of the volunteers had a clinical history of ligament lesions, serious pathologies, or surgeries. A measurement of the length, width, and angle of the CFL relative to the sole of the foot was performed using the MR tools. A virtual model was developed that simulated the visualization of the CFL in the oblique transversal image plane from 35° to 45° using the CFL dimensions of 100 volunteers. The comparison of the simulations with the reconstructed images validated the model and permitted the calculation of the agreement and sensitivity of each technique in the detection of the complete CFL.
Using the simulator, it was possible to obtain the limit angle for complete CFL visualization as a function of its dimensions for any angle of the oblique transversal image plane of the MR.
The results suggest that a single image acquisition technique in the oblique transversal plane at 38° with the foot in anatomical flexion would serve the majority of patients.
用于检测踝关节韧带复合体损伤的磁共振（MR）技术在研究跟腓韧带（CFL）时缺乏理想的准确性。传统技术缺乏敏感性是由于CFL尺寸存在变化。当图像平面与韧带平行时可获得最佳结果。本研究旨在开发一个模型，该模型考虑CFL的宽度、长度和角度参数以及MR图像平面的方向，从而确定一种在足部处于解剖学屈曲状态下的斜横断面平面技术，该技术适用于大多数患者。
为确定这种方向并使其适用于大多数人，使用MR技术获取了100名志愿者踝关节在三维各向同性、容积性矢状面的图像。所有志愿者均无韧带损伤、严重病变或手术的临床病史。使用MR工具测量了CFL相对于足底的长度、宽度和角度。开发了一个虚拟模型，该模型使用100名志愿者的CFL尺寸模拟在35°至45°的斜横断面图像平面中CFL的可视化。将模拟结果与重建图像进行比较，验证了该模型，并允许计算每种技术在检测完整CFL时的一致性和敏感性。
使用模拟器，可以获得在MR斜横断面图像平面的任何角度下，作为CFL尺寸函数的完整CFL可视化的极限角度。
结果表明，对于大多数患者而言，采用足部处于解剖学屈曲状态下38°斜横断面平面的单一图像采集技术即可。
