外伤后副三角骨综合征的影像表现及CT随诊

Imaging Features of Os trigonum Syndrome of the Ankle After Trauma and Follow Up

目的研究踝关节外伤后副三角骨综合征的影像表现及CT随诊评估外伤1年后副三角骨增生、囊变退行性改变发生的预测因素。方法307例急性踝关节外伤患者中52例被纳入一项按常规方法进行的前瞻性观察队列研究。进行X线摄片、MRI及CT检查。分析外伤时的影像表现及一年后CT随诊结果。评估副三角骨退行性改变与临床结果的相关性。结果52例患者中，外伤当时的影像显示：副三角骨周围软组织肿胀52例，积液32例，副三角骨骨髓水肿28例，周围筋膜增厚12例。外伤1年后CT随诊显示：28例骨髓水肿患者中发生副三角骨增生、囊变共25例，32例积液患者中发生副三角骨增生、囊变共16例，12例周围筋膜增厚患者中发生副三角骨增生、囊变共7例。多因素Logistic回归研究发现副三角骨骨髓水肿[OR6．024（95％CI2．452～12．089），P=0．0152]与外伤1年后副三角骨发生增生、囊变相关。结论MRI诊断副三角骨综合征具有很高的价值，踝部急性外伤后MRI显示骨髓水肿强烈预示外伤1年后副三角骨发生增生、囊变等退行性改变。

Objective To study imaging features of Os trigonum syndrome of the ankle after trauma. Methods 52 patients with Os trigonum syndrome underwent X ray, CT and MRI examination after traum, and all the patients underwent follow up CT examination one year after trauma. Results The primary imaging obtained immediately after trauma showed soft tissue swollen around Os trigonum in 52 cases, inflammatory effusion in 32 eases ,bone marrow edema in 28 eases , fas- cial thickening around Os trigonum in 12 cases, after one year, CT follow up imaging showed hyperostosis in 17 eases, cystic change in 13 cases, bone marrow edema of Os trigonum in 28 cases . Conclusion MRI has more valuable in diag- nosis of Os trigonum syndrome , and bone marrow edema on MRI for acute Os trigonum injury is strongly predictive of pro- gression of hyperostosis , cystic change and degenerative change of the Os trigonum.