Department of Neurological Surgery, Chiba Hokuso Hospital, Nippon Medical School.
Department of Neurosurgery, Chiba Shintoshi Rurban Clinic.
Neurol Med Chir (Tokyo). 2022 Dec 15;62(12):552-558. doi: 10.2176/jns-nmc.2022-0118. Epub 2022 Sep 30.
Tarsal tunnel syndrome (TTS) is a common entrapment syndrome whose diagnosis can be difficult. We compared preoperative magnetic resonance imaging (MRI) and operative findings in 23 consecutive TTS patients (28 sides) whose mean age was 74.5 years. The 1.5T MRI sequence was 3D T2* fat suppression. We compared the MRI findings with surgical records and intraoperative videos to evaluate them. MRI- and surgical findings revealed that a ganglion was involved on one side (3.6%), and the other 27 sides were diagnosed with idiopathic TTS. MRI visualized the nerve compression point on 23 sides (82.1%) but failed to reveal details required for surgical planning. During surgery of the other five sides (17.9%), three involved varices, and on one side each, there was connective tissue entrapment or nerve compression due to small vascular branch strangulation. MRI studies were useful for nerve compression due to a mass lesion or idiopathic factors. Although MRI revealed the compression site, it failed to identify the specific involvement of varices and small vessel branches and the presence of connective tissue entrapment.
跗管综合征（TTS）是一种常见的嵌压综合征，其诊断可能较为困难。我们比较了 23 例连续 TTS 患者（28 侧）的术前磁共振成像（MRI）和手术结果，这些患者的平均年龄为 74.5 岁。1.5T MRI 序列为 3D T2* 脂肪抑制。我们将 MRI 结果与手术记录和术中视频进行比较，以评估它们。MRI 和手术结果显示，一侧有神经节（3.6%），其余 27 侧诊断为特发性 TTS。MRI 可在 23 侧（82.1%）上显示神经受压点，但未能显示手术计划所需的详细信息。在另外 5 侧（17.9%）的手术中，有 3 侧存在静脉曲张，每侧有结缔组织嵌压或因小血管分支绞窄引起的神经压迫。MRI 研究对肿块或特发性因素引起的神经压迫有用。尽管 MRI 显示了压迫部位，但未能确定静脉曲张和小血管分支的具体受累情况以及结缔组织嵌压的存在。
