Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University, Goyang, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2023 Feb 3;102(5):e32827. doi: 10.1097/MD.0000000000032827.
An injured posterior talofibular ligament (PTFL) is one of the reasons for chronic lateral ankle instability (CLAI). Previous researches have demonstrated that the PTFL thickness (PTFLT) is associated with chronic ligament injuries. However, ligament hypertrophy is different from ligament thickness. Thus, we created the PTFL cross-sectional area (PTFLCSA) as a diagnostic image parameter to assess the hypertrophy of the whole PTFL. We assumed that the PTFLCSA is a key morphological diagnostic parameter in CLAI. PTFL data were obtained from 15 subjects with CLAI and from 16 normal individuals. The T1-weighted axial ankle-MR (A-MR) images were acquired at the level of PTFL. We measured the PTFLT and PTFLCSA at the posterior aspect of the ankle using our imaging analysis program. The PTFLT was measured as the thickness between point of anterior and posterior fiber of PTFL. The PTFLCSA was calculated as the whole cross-sectional PTFL area. The average PTFLT was 3.43 ± 0.52 mm in the healthy group and 4.89 ± 0.80 mm in the CLAI group. The mean PTFLCSA was 41.06 ± 12.18 mm 2 in the healthy group and 80.41 ± 19.14 mm 2 in the CLAI group. CLAI patients had significantly greater PTFLT ( P < .001) and PTFLCSA ( P < .001) than the healthy group. A receiver operating characteristic curve analysis demonstrated that the optimal cutoff score of the PTFLT was 4.19 mm, with 93.3% sensitivity, 93.7% specificity, and an area under the curve of 0.97. The most suitable cutoff value of the PTFLCSA was 61.15 mm 2 , with 93.3% sensitivity, 100% specificity, and area under the curve of 0.99. Even though the PTFLT and PTFLCSA were both significantly associated with CLAI, the PTFLCSA was a more exact morphological measurement parameter.
距腓后韧带（PTFL）损伤是慢性外侧踝关节不稳定（CLAI）的原因之一。先前的研究表明，PTFL 厚度（PTFLT）与慢性韧带损伤有关。然而，韧带肥大与韧带厚度不同。因此，我们创建了 PTFL 横截面积（PTFLCSA）作为评估整个 PTFL 肥大的诊断图像参数。我们假设 PTFLCSA 是 CLAI 的关键形态学诊断参数。PTFL 数据来自 15 名 CLAI 患者和 16 名正常个体。在 PTFL 水平采集 T1 加权轴位踝关节磁共振（A-MR）图像。我们使用成像分析程序在踝关节后外侧测量 PTFLT 和 PTFLCSA。PTFLT 测量为 PTFL 前纤维和后纤维之间的厚度。PTFLCSA 计算为整个 PTFL 横截面积。健康组的平均 PTFLT 为 3.43±0.52mm，CLAI 组为 4.89±0.80mm。健康组的平均 PTFLCSA 为 41.06±12.18mm 2，CLAI 组为 80.41±19.14mm 2。CLAI 患者的 PTFLT（P<0.001）和 PTFLCSA（P<0.001）明显大于健康组。受试者工作特征曲线分析表明，PTFLT 的最佳截断值为 4.19mm，灵敏度为 93.3%，特异性为 93.7%，曲线下面积为 0.97。PTFLCSA 的最佳截断值为 61.15mm 2，灵敏度为 93.3%，特异性为 100%，曲线下面积为 0.99。尽管 PTFLT 和 PTFLCSA 均与 CLAI 显著相关，但 PTFLCSA 是更准确的形态学测量参数。
