Khan Nasir, Sahota Navdeep, Shepel Michael L, Obaid Haron
Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Faculty of Medicine, University of Saskatchewan, Saskatoon, Canada.
J Med Imaging Radiat Oncol. 2017 Oct;61(5):622-629. doi: 10.1111/1754-9485.12609. Epub 2017 Apr 17.
The transverse ligament in the ankle joint has been described as a labrum-like structure in a previous cadaveric study. The purpose of this study is to assess the spectrum of abnormal changes related to this structure on imaging/MRI, and correlate these findings with other ankle joint findings and patient symptoms.
A retrospective observational review of 172 ankle MRI scans was carried out independently by two fellowship trained musculoskeletal Radiologists. Correlation between abnormal labral changes, other ankle joint findings and patient symptomatology was performed.
Abnormal labral changes were seen in 26% of the MRI scans (n = 44/172) and included signal change, contour abnormality with heterogeneous signal change, linear fluid filled clefts, multidirectional fluid filled clefts, and a macerated labrum. There was a statistically significant association between abnormal labral changes and the presence of Stieda process/os trigonum (P = 0.001), talocrural joint osteoarthritis (P = 0.0003), paralabral cysts (P = 0.0001), imaging features of posterior impingement (P = 0.01), and both medial (P = 0.005) and lateral (P = 0.01) ankle ligament injuries. However, there was no statistically significant association between abnormal labral changes and patient symptoms.
The posterior ankle labrum can develop a spectrum of abnormal MRI appearances in patients with other ankle joint abnormalities. Although this study showed no correlation between patients' symptoms and posterior ankle labral changes, larger studies are needed to examine the biomechanical alterations that may arise from these labral changes.
在先前的一项尸体研究中，踝关节横韧带被描述为一种类似盂唇的结构。本研究的目的是评估在影像学检查/磁共振成像（MRI）上与该结构相关的异常变化范围，并将这些发现与其他踝关节发现及患者症状相关联。
两名接受过肌肉骨骼影像学培训的专科住院医师独立对172例踝关节MRI扫描进行回顾性观察研究。对盂唇异常变化、其他踝关节发现与患者症状之间进行相关性分析。
在26%的MRI扫描中（n = 44/172）可见盂唇异常变化，包括信号改变、伴有信号不均匀改变的轮廓异常、线性液性裂隙、多方向液性裂隙以及破碎的盂唇。盂唇异常变化与施蒂达突/距三角骨的存在（P = 0.001）、胫距关节骨关节炎（P = 0.0003）、盂唇旁囊肿（P = 0.0001）、后撞击的影像学特征（P = 0.01）以及内侧（P = 0.005）和外侧（P = 0.01）踝关节韧带损伤之间存在统计学显著关联。然而，盂唇异常变化与患者症状之间无统计学显著关联。
在患有其他踝关节异常的患者中，后踝盂唇可出现一系列异常的MRI表现。尽管本研究显示患者症状与后踝盂唇变化之间无相关性，但仍需要更大规模的研究来检查这些盂唇变化可能引起的生物力学改变。
