急性跟腱撕裂的低场MRI诊断

The diagnosis of acute achilles tendon tears using MRI with low field

目的探讨低场MRI在急性跟腱损伤中的诊断价值和表现。方法分析29例有踝关节外伤病史、经临床或手术证实且MRI资料完整的跟腱完全撕裂或部分撕裂患者,总结其特征性MRI表现。结果 MRI诊断跟腱完全撕裂10例,MRI特征性表现为肌腱增粗、形态不规则,肌腱束连续性完全中断,肌腱断端回缩呈"杵"状或交错呈"毛刷"状改变,在T_1WI、T_2WI上其内呈混杂高信号。部分性撕裂19例,MRI表现为跟腱增粗,前后径与宽径的比例变大,在T_1WI、T_2WI上肌腱内局限性高信号,肌腱束部分毛糙、不规则,但在矢状位至少有1层面连续。结论低场MRI能清晰显示跟腱形态及内部结构,可以准确诊断撕裂的部位和程度,为临床手术治疗提供准确的依据。

Objective To study the usefulness of MRI with low field for diagnosing acute achilles tendon tears.Methods Twenty-nine patients with traumatic history of the ankle joint and clinically or surgically proved partial and complete achilles tendon tears underwent the examinations of MRI with low field.The MRI findings of all patients were analyzed retrospectively.Results Among 29 patients, complete and partial achilles tendon tears were found in 10 and 19 eases,respectively.On MR images,complete achilles tendon tears appeared as ruptured tendon thickening,continuity interruption,ruptured end backslid into＂clubbed＂form or interlaced into＂bursh＂form, and heterogeneous hyperintensity on T_1WI and T_2WI;partial achilles tendon tears appeared injured tendon thickening,proportion of anteroposterior path vs transverse path increasing,localized hyperintensity within injured tendon on T_1WI and T_2WI,and coarse or irregular shape but injured tendon had at least a continued layer on sagittal plane.Conclusion MRI with low field can clearly show the shape and internal structure of achilles tendon and can accurately identify the location and extent of achilles tendon tears so that it can provide the reliable evidence for surgical treatment.