Emery K H, Bisset G S, Johnson N D, Nunan P J
Department of Radiology, Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-8145, USA.
Pediatr Radiol. 1998 Aug;28(8):612-6. doi: 10.1007/s002470050430.
To determine how well MRI can detect tarsal coalition compared with CT, the current imaging standard.
Coronal and axial CT and MRI were performed within 3 weeks of each other on 40 feet in 20 consecutive patients referred with symptoms of possible tarsal coalition. Scans were read independently in blinded fashion by different imagers. Coalitions were either complete (osseous) or incomplete (non-osseous). Results were compared with available surgical data and clinical follow-up.
Both modalities prospectively identified 15 coalitions (9 patients) and each missed 1 calcaneonavicular coalition. Twenty-three of the remaining 24 feet were negative for coalition on both CT and MRI. An atypical incomplete talocalcaneal coalition seen on CT was not identified prospectively on MRI.
MRI is very good for detecting tarsal coalition and has a high rate of agreement with CT, the imaging "gold standard." When clinical suspicion for coalition is high, CT remains a more cost-effective diagnostic modality. If other causes for ankle pain are also entertained, MRI can be performed and provide nearly equivalent diagnostic accuracy for detecting tarsal coalition.
与当前成像标准CT相比，确定MRI检测跗骨联合的效果如何。
对连续20例因可能存在跗骨联合症状而转诊的患者的40只足，在3周内先后进行了冠状位和轴位CT及MRI检查。扫描结果由不同的影像诊断医师以盲法独立解读。联合可为完全性（骨性）或不完全性（非骨性）。将结果与现有的手术数据及临床随访情况进行比较。
两种检查方法均前瞻性地发现了15例联合（9例患者），且均漏诊了1例跟舟联合。其余24只足中的23只在CT和MRI上均未发现联合。CT上所见的1例不典型不完全距跟联合在MRI上未被前瞻性地识别。
MRI在检测跗骨联合方面表现出色，与成像“金标准”CT的符合率很高。当临床对联合的怀疑程度较高时，CT仍是一种更具成本效益的诊断方法。如果还考虑踝关节疼痛的其他原因，则可进行MRI检查，其在检测跗骨联合方面能提供几乎同等的诊断准确性。
