Spring韧带复合体损伤的MRI诊断

MRI Diagnosis of Spring Ligament Complex Injuries

目的探索Spring韧带损伤的MRI表现。方法搜集经手术证实Spring韧带损伤并行MRI检查患者34例,描述Spring韧带损伤的MRI信号特征,测量损伤韧带直径,以及有无伴随损伤,使用SPSS 22.0软件对数据进行统计分析。结果Spring韧带内上束损伤中,22例(64.7%)表现为PD信号增高,7例(20.6%)信号不均匀,韧带直径>4 mm者28例(82.4%),>5 mm者18例(52.9%),<2 mm者2例(5.9%),4例出现韧带扭曲,5例出现韧带完全断裂,两断端间出现撕裂沟,23例存在胫骨后肌腱损伤,13例伴有胫-Spring韧带损伤,8例Spring韧带足底束损伤,表现为韧带增粗和信号不均。结论MRI图像上,Spring韧带内上束>4 mm或<2 mm,信号增高或不均、撕裂沟出现时提示其损伤。内上束损伤常伴有胫骨后肌腱损伤和胫-Spring韧带损伤。Spring韧带足底束损伤较少见,主要表现为韧带信号不均及增粗。

Objective MRI findings of the spring ligament complex Injuries were investigated.Methods MRI findings in the feet of 34 patients with SLC injury were analyzed from May 2013 to May 2018,signal intensity characteristics and the image plane of SLC were obtained.The diameter and length were measured,some accompanying injuries were noted,and the data was analyzed using the SPSS 22.0 software.Results The differentiation of three parts of the SLC could be successfully made by the MR imaging.For the superomedial calcaneonavicular ligament(smCNL),64.7 percent cases showed increased signal intensity on PD images and 20.6 percent of cases showed heterogeneous signal on MR imaging.In 82.4%of the patients,mean diameter of smCNL was larger than 4 mm;in 52.9%of the patients,the mean diameter of smCNL was larger than 5 mm,while 5.9 percent of patients had less than 2 mm diameter.Twisted ligaments were observed in 4 patients,completely ruptured ligaments and the ligaments tear gap between two torn ends were observed in 5 patients.67.6%of cases had posterior tibial tendon injury and 38.2 percent cases were complicated with Tibio-Spring ligament injury.Spring plantar ligament injury was observed in 8 patients,in which there was ligament thickening and heterogeneous signal on MR imaging.Conclusion SmCNL injuries ofen showed diameters larger than 4 mm or less than 2 mm,heterogeneous signal or a tear gap on MR imaging.SmCNL is usually complicated by posterior tibial tendon injury and tibial-Spring ligament injury.Spring plantar ligament injury was rarely observed,which showed the heterogeneous signal on MR imaging and ligament thickening.