低场MRI在跟腱损伤中的应用价值

The application of low-field-strength MRI in Achilles tendon injury

目的探讨低场MRI在跟腱损伤诊断及术后随访中的应用价值。方法 15例跟腱损伤患者经低场四肢专用磁共振多序列检查,其中7例行缝补术后随访,分析其低场MRI表现,并与5例正常跟腱比较。结果 5例正常跟腱矢状面各序列显示呈条带状均匀低信号。1例利器切割伤显示跟腱下段大部分中断,断面整齐。5例部分撕裂显示跟腱增粗,内部信号不均匀,部分纤维束连续。9例完全性撕裂均显示跟腱连续性完全中断,2例表现为肌腱普遍增粗、形态不规则,T_1WI、T_2WI上信号弥漫增高,7例表现为肌腱局部增粗、断裂,断端回缩呈"杵"状改变或扭曲,T_1WI、T_2I上中断处呈高信号。7例术后随访显示高信号强度逐渐下降。结论低场磁共振能够明确地显示跟腱损伤的部位、程度及形态、信号改变,在跟腱损伤的诊断和术后随访方面能提供重要价值。

Objective To study the application of low-field-strength MRI in diagnosis and follow-up of Achilles tendon injury. Methods Fifteen cases of Achilles tendon injury were examined with the low-fieht-strength MRI using sagittal T1WI, T2WI, GE STIR-weighted and axial T1WI pulse sequences. Seven patients also had follow-up MRI after surgical repair. The features of MRI was analyzed retrospectively and compared with five normal cases. Results All five cases of normal Achilles tendons showed low signal intensities on all pulse sequences. In one patient whose tendon was cut by a sharp instrument, the cut edges of the interrupted tendon were sharp and regular. Partial lacerations in five patients showed tendon thickening with heterogeneous signal intensities and some intact fibrous bundles. Of nine cases of complete tendon rupture, two demonstrated tendon thickening with irregular shapes, discontinuous fibrous bundles, and mixed hyperintensity on T1WI and T2WI. Seven showed tendon retraction. The high signal intensities decreased gradually with time after surgical repair. Conclusion Low-field-strength MRI clearly depicts the location, severity, signal changes of Achilles tendon tear. It is valuable for diagnosis and follow-up of Achilles tendon injury.