Carretta G, De Nicola T, Gongolo R, Villabruna M
Servizio di Radiologia, Ospedale de Gironcoli, Conegliano Veneto (Treviso).
Radiol Med. 1996 May;91(5):563-9.
While Magnetic Resonance Imaging (MRI) has become a routine diagnostic method in knee studies, little has been published about ankle injuries. This is probably due to the anatomic complexity of the bone and ligament structures of this joint. Our study was aimed at assessing the yield of MRI of the ankle with a cost-effective, compact, low-field (0.2 T) M(R) system (Artoscan, Esaote). January, 1994, to August, 1995, 148 ankle examinations were carried out in a series of patients whose age ranged 7 to 75 years. In 56.7% of cases the exam was performed because of acute joint strain and in 43.3% for pain and chronic ankle instability. In 16.2% of cases the exam was negative; in 41.2% osteochondral injuries were found (which are not considered in this paper) and in 62.1% of cases ligament and tendon injuries were demonstrated. As for the latter, 46 patients had anterior talofibular rupture, 3 associated anterior talofibular and calcaneofibular ligament injuries, 9 tenosynovitis of extensor or flexor tendons, 2 tendon rupture and 17 Achilles tendon conditions (10 chronic tendinitis, 2 bone metaplasia and 5 tendon rupture cases). Three tarsal tunnel syndromes and 3 accessory soleus muscles were also observed. Surgical correlation was available only in 17 patients; after radiography and MRI, the vast majority of patients was treated nonoperatively. Nevertheless, a good correlation was demonstrated between M(R) and intraoperative findings or clinical and US findings. The authors believe that low-field MRI can be a very useful diagnostic tool in the study of ankle tendon injuries and to assess the severity of ligament injuries, for better treatment planning.
虽然磁共振成像(MRI)已成为膝关节研究中的常规诊断方法,但关于踝关节损伤的报道却很少。这可能是由于该关节的骨骼和韧带结构解剖复杂。我们的研究旨在使用一种经济高效、紧凑的低场(0.2T)MRI系统(Artoscan,Esaote)评估踝关节MRI的诊断价值。1994年1月至1995年8月,对一系列年龄在7至75岁的患者进行了148次踝关节检查。在56.7%的病例中,检查是因为急性关节扭伤进行的,在43.3%的病例中是因为疼痛和慢性踝关节不稳。在16.2%的病例中检查结果为阴性;在41.2%的病例中发现了骨软骨损伤(本文未考虑),在62.1%的病例中显示有韧带和肌腱损伤。至于后者,46例患者有距腓前韧带断裂,3例伴有距腓前韧带和跟腓韧带联合损伤,9例伸肌腱或屈肌腱腱鞘炎,2例肌腱断裂,17例跟腱病变(10例慢性肌腱炎,2例骨质化生和5例肌腱断裂病例)。还观察到3例跗管综合征和3例副比目鱼肌。仅17例患者有手术对照;在进行X线摄影和MRI检查后,绝大多数患者接受非手术治疗。然而,MRI与术中发现或临床及超声检查结果之间显示出良好的相关性。作者认为,低场MRI在踝关节肌腱损伤研究及评估韧带损伤严重程度方面可能是一种非常有用的诊断工具,有助于更好地制定治疗方案。