踝管综合征MRI评价及常见病因分析

Tarsal Tunnel Syndrome:MRI Features and Analysis of Commonly Relating Conditions

目的探索MRI对踝管综合征的诊断价值。方法回顾性研究29例踝管综合征,观察不同病因导致胫神经或其分支卡压MRI特点、结果差异并分析各疾病MRI特征。同时观察20例健康志愿者正常踝管MRI影像解剖特点。结果29例踝管综合征中,腱鞘巨细胞瘤4例,腱鞘囊肿9例,滑膜肉瘤1例,神经鞘瘤6例,神经纤维瘤1例,跟距桥7例,足底静脉曲张1例。29例均导致胫神经血管束受压推移,19例出现神经肿胀,17例出现静脉扩张,7例肌肉失神经改变,23例出现屈肌支持带受压、推移。对各种病因引起卡压导致结果进行比较。20例健康志愿者均清楚显示踝管内的解剖细节及胫神经、分支走行、信号特点。结论MRI可以对踝管综合征做出良好评价,并对引起踝管综合征病因诊断具有重要价值。

Objective To explore the diagnostic value of MRI for tarsal tunnel syndrome.Methods A retrospective study of 29 cases of tarsal tunnel syndrome was performed to observe the MRI characteristics of tibial nerve or its branch compression caused by different etiologies,the differences in results,and to analyze the MRI characteristics of various diseases.At the same time,the anatomical characteristics of MRI images of normal tarsal tunnel in 20 healthy volunteers were observed.Results 29 patients were observed meticulously,that consisted of 4 cases giant cell tumor of tendon sheath,9 cases Ganglion Cyst,1 case synvial sarcoma,6 cases Schwannoma,1 case neurofibroma,7 cases talocalcaneal coalition,and 1 varicose vein of pelma.The compression of tibial neurovascular bundles were discovered in all cases,19 cases had nerve swelling,17 cases resulted in varicose veins,7 cases had muscle denervation,23 cases had compression and extension of flexor retinaculum.The differences of the results were compared.20 cases of healthy volunteers clearly showed the anatomical details in the tarsal tunnel,the course and signal intensity of of the tibial nerve and its branches.Conclusion MRI can make a good evaluation of tarsal tunnel syndrome,and has important value for finding causes of tarsal tunnel syndrome.