O'Connor P J, Bos C F, Bloem J L
Department of Radiology, The General Infirmary at Leeds, UK.
Skeletal Radiol. 1998 Aug;27(8):440-4. doi: 10.1007/s002560050414.
To correlate radiographic and MR appearances with surgical findings to determine the accuracy of these modalities in demonstrating tarsal navicular (TN) relations in order to select the appropriate surgical intervention.
Fourteen consecutive patients with 19 club feet had anteroposterior and lateral radiographs and magnetic resonance (MR) imaging performed. Blinded retrospective interpretation of these studies was correlated with surgical findings. Movement artifact was responsible for initial non-diagnostic MR scans in 3 out of 19 feet.
Plain radiographs and MR imaging had sensitivities of 79% and 84% respectively for TN subluxation, while both modalities had 100% positive predictive value for TN subluxation. Each modality produced indeterminate results in cases where subluxation was present at surgery, but in combination there were no false negatives.
Radiography confidently predicted the TN alignment in the majority of cases. MR demonstrated TN relationships in all cases where radiography was indeterminate. It is proposed that MR has a potential role to demonstrate TN relationships when radiography is indeterminate or when there is disparity between the clinical and radiographic assessment.
将影像学和磁共振成像（MR）表现与手术结果相关联，以确定这些检查方式在显示舟状骨（TN）关系方面的准确性，从而选择合适的手术干预措施。
连续14例患有19只马蹄内翻足的患者接受了前后位和侧位X线片及磁共振成像（MR）检查。对这些研究进行盲法回顾性解读，并与手术结果相关联。19只足中有3只因运动伪影导致最初的MR扫描无法诊断。
对于TN半脱位，X线平片和MR成像的敏感性分别为79%和84%，而两种检查方式对TN半脱位的阳性预测值均为100%。在手术中存在半脱位的病例中，每种检查方式都产生了不确定的结果，但联合使用时没有假阴性。
在大多数情况下，X线摄影能够可靠地预测TN的对线情况。MR在X线摄影不确定的所有病例中都能显示TN的关系。建议在X线摄影不确定或临床与影像学评估存在差异时，MR在显示TN关系方面具有潜在作用。
