Farooki S, Yao L, Seeger L L
Department of Radiological Sciences, University of California at Los Angeles School of Medicine, USA.
Radiology. 1998 May;207(2):357-60. doi: 10.1148/radiology.207.2.9577480.
To determine the effectiveness of magnetic resonance (MR) imaging in the diagnosis of anterolateral impingement of the ankle.
MR images were reviewed in 12 patients (12 ankles) with arthroscopically proved anterolateral impingement and in 19 control subjects (20 ankles) with diagnoses other than impingement. MR images were scored by means of consensus of two musculoskeletal radiologists and independently by a third radiologist. Patients underwent imaging at 1.5 T, with use of standard imaging sequences and a dedicated extremity coil.
For the consensus reading, the sensitivity, specificity, and accuracy of MR imaging for the diagnosis of impingement were 42%, 85%, and 69%, respectively. The frequency of lateral gutter fullness and anterior talofibular ligament thickening on MR images was higher in the 12 ankles with impingement (seven [58%] and seven [58%] ankles, respectively) than in the 20 control ankles (seven [35%] and five [25%] ankles, respectively), but these trends did not reach statistical significance. Interobserver agreement for anterior talofibular ligament thickening was high, whereas that for lateral gutter fullness was fair.
Conventional MR imaging of the ankle is insensitive for anterolateral impingement. Anterior talofibular ligament thickening and soft-tissue fullness in the lateral gutter may be suggestive of the diagnosis, but the reliability of the latter finding is questionable.
确定磁共振（MR）成像在诊断踝关节前外侧撞击综合征中的有效性。
回顾性分析12例（12个踝关节）经关节镜证实为前外侧撞击综合征患者以及19例（20个踝关节）诊断为非撞击综合征的对照者的MR图像。MR图像由两名肌肉骨骼放射科医生共同评分，并由第三名放射科医生独立评分。患者采用1.5T设备成像，使用标准成像序列和专用肢体线圈。
对于共同阅片，MR成像诊断撞击综合征的敏感性、特异性和准确性分别为42%、85%和69%。12个有撞击综合征的踝关节在MR图像上出现外侧沟饱满和距腓前韧带增厚的频率（分别为7个[58%]和7个[58%]踝关节）高于20个对照踝关节（分别为7个[35%]和5个[25%]踝关节），但这些趋势未达到统计学意义。观察者间对距腓前韧带增厚的一致性较高，而对外侧沟饱满的一致性一般。
踝关节常规MR成像对前外侧撞击综合征不敏感。距腓前韧带增厚和外侧沟软组织饱满可能提示诊断，但后者的可靠性存疑。
