Rosenberg Z S, Cheung Y, Jahss M H, Noto A M, Norman A, Leeds N E
Department of Radiology, Hospital for Joint Diseases/Orthopedic Institute, New York, NY 10003.
Radiology. 1988 Oct;169(1):229-35. doi: 10.1148/radiology.169.1.3420263.
Computed tomography (CT) and magnetic resonance (MR) imaging were performed in 32 cases of clinically suspected chronic tears of the posterior tibial tendon. Surgery was performed in 22 patients (69%). Each case was classified radiographically and surgically as normal or a type 1, type 2, or type 3 rupture. The sensitivity and specificity of CT were 90% and 100%, respectively, while those of MR imaging were 95% and 100%. The accuracy in detecting ruptures was 91% for CT and 96% for MR imaging. The overall accuracy, which reflected the percentage of cases correctly diagnosed as well as those correctly classified, was 59% for CT and 73% for MR imaging. Although the differences between the CT and MR imaging parameters were not statistically significant (possibly due to the small population), the results suggest that MR imaging is the method of choice for detecting ruptures of the posterior tibial tendon. MR imaging provided greater definition of tendon outline, vertical splits, synovial fluid, edema, and degenerated tissue. CT was superior to MR imaging in showing associated bone abnormalities such as periostitis, subtalar osteoarthritis, and subtalar dislocation.
对32例临床怀疑胫后肌腱慢性撕裂的患者进行了计算机断层扫描（CT）和磁共振成像（MR）检查。22例患者（69%）接受了手术治疗。每例均通过影像学和手术分类为正常或1型、2型或3型断裂。CT的敏感性和特异性分别为90%和100%，而MR成像的敏感性和特异性分别为95%和100%。CT检测断裂的准确率为91%，MR成像为96%。反映正确诊断和正确分类病例百分比的总体准确率，CT为59%，MR成像为73%。尽管CT和MR成像参数之间的差异无统计学意义（可能由于样本量小），但结果表明MR成像是检测胫后肌腱断裂的首选方法。MR成像能更清晰地显示肌腱轮廓、垂直撕裂、滑液、水肿和退变组织。CT在显示相关骨异常如骨膜炎、距下骨关节炎和距下关节脱位方面优于MR成像。
