Rosenberg Z S, Beltran J, Cheung Y Y, Colon E, Herraiz F
Department of Radiology, Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
AJR Am J Roentgenol. 1997 Jan;168(1):141-7. doi: 10.2214/ajr.168.1.8976937.
Our objective is to describe the characteristic MR imaging features of longitudinal tears of the peroneus brevis tendon and to describe pathologic conditions and normal variants that are associated with these tears which may require surgical intervention at the time of primary tendon repair.
We retrospectively reviewed 10 MR images of asymptomatic volunteers and 31 MR images of 27 patients with evidence of longitudinal splits of the peroneus brevis tendon. Seven of these cases were surgically proven. In addition, we assessed five pathologic conditions and normal variants: lateral collateral ligamentous tears; injuries to the superior peroneal retinaculum; low-lying muscle belly of the peroneus brevis tendon; peroneus quartus muscle; and convex, flat, or irregular retromalleolar groove.
In the patient's group, we saw longitudinal splits as clefts and an irregularity of the contour of the peroneus brevis tendon with (71%) and without (29%) signal changes on proton density-weighted and T2-weighted MR imaging sequences. Divisions of the split tendon assumed a characteristic C-shaped configuration that partly enveloped the peroneus longus tendon. Fifteen cases revealed other pathologic conditions and normal variants known to be associated with or to predispose to tears of the peroneus brevis tendon. These include ankle ligamentous tears (n = 3); abnormal superior peroneal retinaculum (n = 4); low-lying muscle belly of the peroneus brevis tendon (n = 1); peroneus quartus muscle (n = 2); and convex, flat, or irregular retromalleolar groove (n = 15). MR imaging revealed tears in all patients with surgical proof (n = 7).
MR imaging is a useful technique for revealing longitudinal tears of the peroneus brevis tendon as well as showing anatomic and pathologic factors associated with or predisposed to tears.
我们的目的是描述腓骨短肌腱纵向撕裂的特征性磁共振成像（MR）表现，并描述与这些撕裂相关的病理状况和正常变异，这些情况在初次肌腱修复时可能需要手术干预。
我们回顾性分析了10例无症状志愿者的MR图像以及27例有腓骨短肌腱纵向撕裂证据患者的31例MR图像。其中7例经手术证实。此外，我们评估了五种病理状况和正常变异：外侧副韧带撕裂；腓骨上支持带损伤；腓骨短肌腱低位肌腹；第四腓骨肌；以及后踝沟凸起、扁平或不规则。
在患者组中，我们在质子密度加权和T2加权MR成像序列上看到纵向撕裂表现为裂缝以及腓骨短肌腱轮廓不规则，有信号改变的占71%，无信号改变的占29%。撕裂肌腱的分支呈特征性的C形，部分包绕腓骨长肌腱。15例显示出已知与腓骨短肌腱撕裂相关或易导致其撕裂的其他病理状况和正常变异。这些包括踝关节韧带撕裂（3例）；腓骨上支持带异常（4例）；腓骨短肌腱低位肌腹（1例）；第四腓骨肌（2例）；以及后踝沟凸起、扁平或不规则（15例）。MR成像显示所有经手术证实的患者（7例）均有撕裂。
MR成像是一种有用的技术，可显示腓骨短肌腱的纵向撕裂以及与撕裂相关或易导致撕裂的解剖和病理因素。
