Department of Radiology, Beijing Jishuitan Hospital, Beijing Institute of Traumatology and Orthopedics, Beijing 100035, China.
Department of Radiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing 100020, China.
Chin Med J (Engl). 2018 May 5;131(9):1051-1058. doi: 10.4103/0366-6999.230721.
Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities.
Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed.
The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons.
Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.
手部损伤在运动中很常见，如滑雪和球类运动。导致手部和手指畸形的一个主要原因是韧带和肌腱损伤。本研究的目的是探讨高分辨率 3T 磁共振成像（MRI）是否能显示手指和拇指的复杂解剖结构，特别是肌腱和韧带，并为运动相关损伤导致的韧带和肌腱损伤的临床重要手指和拇指畸形提供准确的诊断。
从 8 具尸体中采集了 16 只未经防腐处理的新鲜手。共有 20 名健康志愿者的手和 44 名因运动相关损伤导致手指或拇指畸形的患者纳入本研究。所有受试者均行 MRI 检查，横轴位、冠状位和矢状位分别行 T1 加权像和质子密度加权像（PD FS）。随后，将 16 只尸体手用带锯切成 2 毫米厚的薄片（冠状面 6 个，矢状面 6 个，轴面 4 个）。分析 20 名健康志愿者和 44 名（经手术证实）患者手指和拇指掌指关节（MCPJ）尺侧副韧带（UCL）的肌腱的解剖切片与 MRI 特征之间的相关性。
16 只尸体手和 20 名志愿者手的正常韧带和肌腱在 MRI 的所有序列上均显示均匀的低信号强度。在 44 例手指或拇指肌腱和韧带损伤的患者中，12 例拇指 MCPJ UCL 损伤（Stener 病变=8 例，非 Stener 病变=4 例），6 例中央束损伤，12 例末节肌腱损伤，14 例屈指深肌腱损伤。韧带和肌腱断裂表现为信号强度增加，定义不良，连续性中断，受累韧带和肌腱信号不均匀。
运动相关手指和拇指畸形较为常见。MRI 是评估手指和拇指解剖和病理状况的准确方法。它是对手部运动相关韧带和肌腱损伤进行准确诊断的有用工具。
