专用四肢关节低场MRI在踝部损伤中的应用

Application of low field intensity joint MRI in ankle injury

目的评价专用四肢关节低场磁共振成像（magnetic resonance imaging,MRI）在踝部损伤中的诊断价值。方法回顾分析2007年1月~2010年6月在本院就治的50例（50踝）资料齐全的经关节镜检或（和）切开手术证实的病例资料并进行整理,重点评价其对踝关节韧带、骨挫伤、隐匿性骨折、距骨骨软骨、肌腱的诊断能力。X线片及计算机断层扫描（computed tomography,CT）所能够诊断的骨折病例未纳入本研究。结果专用四肢关节低场MRI对于距腓前韧带损伤具有较高的诊断敏感度（88.9%）,而对于跟腓韧带的诊断敏感度只有50%,对于三角韧带损伤的诊断非常敏感（100%）,对于下胫腓联合损伤的诊断敏感度为100%;对于肌腱损伤、骨挫伤、隐匿性骨折能正确作出诊断;对于距骨骨软骨损伤总的敏感度为70.6%,对Mintz分级方法3~5级距骨骨软骨损伤的诊断敏感度为90%,而对于Mintz分级方法1~2级距骨骨软骨损伤的诊断敏感度只有42.9%,软骨下的骨水肿可以较为准确地预测距骨骨软骨损伤。结论专用四肢关节低场MRI在踝关节损伤诊断方面具有良好的应用价值,可为临床治疗提供依据。

Objective To observe the diagnostic value of the low field intensity joint magnetic resonance imaging（MRI） in traumatic ankles.Methods Through a retrospective examination and collection of 50 cases with complete information and checked by arthroscope or/and operated from Jan 2007 to Jun 2010,the diagnostic value ligament of the ankle joint,bone contusion,occult fracture,talus cartilage,and tendon could be evaluated.Cases of fracture for which could be diagnosed by X rays and CT were not included in this research.Results The special low field intensity joint MRI had a high diagnostic sensitivity of 88.9% to ligamentum talofibulare anterius,but was only 50% sensitive to ligamentum calcaneofibulare.Its sensitivity to injury of ligamentum deltoideum and distal tibiofibular syndesmosis was up to 100%.Tendon injury,bone contusion and occult fracture could be exactly diagnosed.Its total sensitivity on talus cartilage traumatism was 70.6%.Its diagnosis sensitivity to talus cartilage traumatism at the 3rd-5th period by Mintz was 90%,with a lower one of 42.9% at the 1st-2nd period.Talus cartilage traumatism could be exactly predicted by osseous tissue dropsy below cartilage.Conclusion The special low field intensity joint MRI is highly applicable to the diagnosis on ankle joint traumatism and facilitates clinical treatment.