踝关节45°轴斜位MRI扫描诊断下胫腓前韧带慢性损伤的应用评价被引量：5

45° Oblique MRI Scanning of Ankle Joint for Diagnosis of Chronic Injuries of Anterior Inferior Tibiofibular Ligament

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摘要目的：评价踝关节45°轴斜位MRI扫描诊断下胫腓前韧带（anterior inferior tibiofibular ligament,AITFL）慢性损伤的应用价值,为临床诊断AITFL损伤提供有效方法。方法：2011年3月~2013年2月,前瞻性搜集31例慢性踝关节前外侧撞击综合征患者临床资料：男15例,女16例;年龄22~63岁,平均34.5岁。所有患者经至少6个月以上的保守治疗无效后行踝关节镜手术。受伤至手术时间为7~10个月,平均8.4个月。术前摄踝关节X线片及行常规MRI以及45°轴斜位MRI扫描诊断AITFL损伤情况。以术中关节镜下探查AITFL损伤情况作为金标准,与术前MRI扫描结果进行统计学比较分析。结果：手术探查16例存在AITFL损伤,15例未见损伤。术前常规MRI诊断AITFL损伤的灵敏度75%,特异度66.7%,Youden指数42.3%,Kappa值0.418。术前45°轴斜位MRI扫描诊断AITFL损伤的灵敏度87.5%,特异度93.3%,Youden指数80.8%,Kappa值0.807;45°轴斜位MRI扫描各指标均显著高于常规MRI扫描（P〈0.05）。Kappa值显示45°轴斜位MRI扫描与手术探查结果的一致性和可靠性较高。结论：单纯根据常规MRI扫描诊断AITFL损伤可靠性低,45°轴斜位MRI诊断AITFL损伤可靠性高、准确性好,有重要的临床参考价值。 Objective To evaluate the clinical value of 45° oblique MRI scanning of ankle joint for diagnosis of chronic injury of anterior inferior tibiofibular ligament（AITFL）. Methods From March 2011 to February 2013,31 patients with ankle anterolateral impingement syndrome were collected,including 15 men and 16 women with an average age of 34.5 years（22 ~63）. The patients received arthroscopic debridement after at the least 6 months of unsatisfactory conservative treatment. The duration from injury to operation was8.4（7 ~10） months. X-ray,conventional MRI scanning and 45° oblique MRI scanning of ankle joints were performed before the operation,and their results were compared based on the arthroscopic exploration. Results According to the arthroscopic exploration,16 patients was confirmed to have AITFL injuries. The sensitivity,specificity,Youden index and Kappa value of 45° oblique MRI scanning（87.5%,93.3%,80.8% and 0.807,respectively） were significantly higher than that of conventional MRI scanning（ 75%,66.7%,42.3% and0.418,respectively）（P0.05）. There were high consistency and reliability between Kappa value of 45°oblique MRI and arthroscopic exploration. Conclusion 45° oblique MRI scanning for diagnosis of AITFL injury revealed higher reliability and accuracy than conventional MRI scanning.

作者闵红巍刘克敏徐峰韩新祚顾蕊亓攀

机构地区首都医科大学康复医学院中国康复研究中心北京博爱医院骨关节康复科

出处《中国运动医学杂志》 CAS 北大核心 2015年第4期370-374,共5页 Chinese Journal of Sports Medicine

基金中国康复研究中心科研项目(2011-33) 北京丰台区卫生系统科学研究项目(2014-丰台)

关键词 MRI扫描 45°轴斜位MRI 下胫腓前韧带损伤影像学诊断 MRI scanning 45° oblique MRI anterior inferior tibiofibular ligament injury

分类号 R873 [医药卫生—运动医学]

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