MRI评估慢性踝关节不稳患者距骨和腓骨位置

MR Image Identification of the Fibular and Talus Position in Patients with Chronic Ankle Instability

目的:评估慢性踝关节不稳患者距骨和腓骨在踝关节中的位置。方法:100名测试对象纳入本研究,其中50名为慢性踝关节不稳患者(A组),50名为非踝关节不稳疾病、至我院就诊的患者(B组)。每名测试对象行MRI检查,并在横断面上采用2种方法测量腓骨在踝穴内的前后位置:采用轴向踝指数(ax-ial malleolar index,AMI)以距骨为参照物测量腓骨的位置;采用踝间指数(inter malleolar index,IMI)以内踝为参照物测量腓骨的位置。另外,我们还应用一种新的测量方法:踝距指数(malleolar talus index,MTI)来测量距骨在踝穴内的旋转位置。结果:以距骨为参照物时,踝关节不稳组AMI明显高于较对照人群(11.04°±5.66°vs 7.68°±5.38°,P<0.01);但以内踝为参照时,踝关节不稳组IMI与对照人群组相比无显著差异(7.22°±3.44°vs 7.93°±3.36°,P=0.03);以内踝为参照物测量距骨在踝穴内的旋转位置时,踝关节不稳组MTI明显高于较对照人群(89.46°±2.64°vs 85.99°±2.24°,P<0.01)。结论:慢性踝关节不稳患者存在距骨内旋现象,但腓骨在踝穴内的位置并未发生改变。

Objective To evaluate the fibular and talus position in patients with ankle instability.Methods One hundred subjects were included in this study,which including 50 patients with chron-ic ankle instability（group A） and 50 patients（group B） from the author＇s institution for reasons unrelat-ed to ankle instability. Magnetic resonance imaging was conducted for both groups. Then the positionof the fibular at the axial plane was evaluated through two ways： in relation to the talus（axial malleo-lar index,AMI）and in relation to the medial malleolus（inter malleolar index,IMI）. Meanwhile,the rota-tion of the talus was also measured using a new index： malleolar talus index（MTI）. Results Usingthe talus as a reference,the average AMI in group A increased significantly when compared to that inthe control group（11.04° ± 5.66° vs 7.68° ± 5.38°,P〈0.01）. However,using the medial malleolar as areference,there was no significant difference in the IMI between group A and the control group（7.22°± 3.44° vs 7.93° ± 3.36°,P=0.3）.The MTI increased significantly in group A compared to that in thecontrol group（89.46° ± 2.64° vs 85.99° ± 2.24°,P〈0.01）.Conclusion The patients with ankle instabili-ty tends to have an internally rotated talus. However,no significant variation in fibular position isfound in patients with chronic ankle instability.