Schweitzer M E, Caccese R, Karasick D, Wapner K L, Mitchell D G
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Radiology. 1993 Sep;188(3):655-9. doi: 10.1148/radiology.188.3.8351328.
To assess the range of appearance of both torn and normal posterior tibial tendons (PTTs) and to evaluate secondary signs related to abnormal biomechanics as aids in diagnosing PTT tears, 23 patients with complete PTT tears and 34 control patients were examined with magnetic resonance imaging at 1.5 T. Examiners were blinded to diagnosis. The diameter of the PTT was measured at the insertion and at the level of the ankle. The torn and control PTTs were bulbous distally (respective mean values, 6.2 mm vs 4.6 mm), with overlap in the range of tendon size. All PTTs also had overlap in the frequency of intra-tendon signal intensity (torn PTTs, 83%, vs control PTTs, 41%; T1-weighted, 61%, vs T2-weighted, 22%). The presence of a talonavicular abnormality was both a sensitive (82%) and specific (100%) sign of a PTT tear. The presence of medial tubercle hypertrophy (sensitivity, 89%; specificity, 75%) and an accessory navicular bone (sensitivity, 20%; specificity, 100%) were useful secondary signs of a complete PTT tear.
为评估撕裂和正常胫后肌腱（PTT）的外观范围，并评估与异常生物力学相关的继发征象以辅助诊断PTT撕裂，对23例PTT完全撕裂患者和34例对照患者进行了1.5T磁共振成像检查。检查人员对诊断结果不知情。在肌腱附着处和踝关节水平测量PTT的直径。撕裂的和对照的PTT在远端呈球根状（各自的平均值分别为6.2mm和4.6mm），肌腱大小范围有重叠。所有PTT在肌腱内信号强度频率方面也有重叠（撕裂的PTT为83%，对照的PTT为41%；T1加权像为61%，T2加权像为22%）。距舟关节异常的存在是PTT撕裂的一个敏感（82%）且特异（100%）的征象。内侧结节肥大（敏感性89%；特异性75%）和副舟骨（敏感性20%；特异性100%）的存在是PTT完全撕裂的有用继发征象。
