急性跟腱断裂预后相关因素的MRI分析

MRI analysis of factors associated with prognosis in the acute Achilles tendon rupture

目的探讨急性跟腱断裂患者术前MRI在判断预后中的价值。方法回顾性分析2013年1月-2015年7月在新疆医科大学第一附属医院接受手术治疗的急性跟腱断裂患者的MRI资料并结合手术所见,量化跟腱断裂患者的MRI表现和预后情况,应用SPSS 17.0统计学软件进行单因素及多因素Logistic回归分析。结果对74例接受手术治疗的急性跟腱断裂患者用美国足踝外科协会踝与后足功能评分评价标准评分,其中优54例(占75.7%),良、可18例(占24.3%),差为0例。经统计学分析发现断裂部位、是否合并骨折和不同断端间隙与术后改善率具有相关性(P<0.05),且中段跟腱断裂、合并骨折和越宽的断端间隙往往预示了较低的术后改善率。结论断裂部位、合并骨折、断端间隙与跟腱断裂患者的预后有明确的相关性。

Objective To investigate the predictive value of preoperative MRI in the prognosis of patients with acute Achilles tendon rupture. Methods All cases with acute Achilles tendon rupture underwent surgery in our hospital from January 2013 to July 2015 were analyzed retrospectively. The single factor and multi-factor Logistic regression analysis in SPSS 17.0 software were used to quantified MRI findings and the prognosis of the patients. Results A total of 74 patients with acute Achilles tendon rupture who underwent surgical treatment were evaluated with the ankle and foot function evaluation criteria of AOFAS, and 56 patients had the excellent results （75.7%）, 18 patients had good results （24.3%）, 0 had bad result. Statistical analysis found that the postoperative improvement rate are associate with rupture portion, combined fracture or not and the different ruptured gap （P 〈 0.05）. The mid- portion Achilles tendon rupture, rupture combined with fracture and the wider ruptured gap reflected the lower postoperative improvement rate. Conclusions The ruptured portion of Achilles tendon, rupture combined with fracture or not and ruptured spatium were correlated with the prognosis of acute Achilles tendon rupture.