磁共振成像在跟腱断裂诊断中的价值

MIR in the diagnosis of achilles tendon rupture

目的 探讨跟腱断裂及其术后磁共振成像(MRI)的特征。方法 回顾性分析淮南东方医院集团总院2019年2月至2021年11月21例经手术与临床诊断为跟腱断裂患者的临床影像资料。21例患者均行常规MRI横断位T1WI,矢状位T1WI、T2WI和STIR,冠状位T2WI-STIR序列扫描,其中3例使用Avanto 1.5T MRI仪,18例使用Spectra 3.0T MRI仪。结果 21例跟腱断裂中,20例为完全性断裂,1例为部分性断裂;右侧跟腱断裂14例,左侧跟腱断裂7例;男性19例,女性2例。跟腱断裂的MRI表现为,腱束连续性中断(20例),部分中断(1例),断端回缩变形,断端呈波浪状(3例)、马尾状(10例)、毛刷状(3例)、杵状(5例);断端处水肿、充满血液,于MRI T2WI和STIR呈高信号。冠状位STIR显示跟腱断裂处间隙及断缘形态上优于矢状位。结论 MRI可清楚显示跟腱的形态结构,精确诊断跟腱断裂的部位和程度,对临床的诊治具有较高的价值,可作为跟腱断裂影像学检查方法的首选。

Objective To explore achilles tendon(AT) rupture and its magnetic resonance imaging(MRI) characteristics after operation. Methods A retrospective analysis was performed on the clinical imaging data of 21 patients with AT rupture in the General Hospital of Huainan Oriental Hospital Group from February 2019 to November 2021. All patients underwent the conventional MRI(transverse T1 WI, sagittal T1 WI, T2 WI and STIR and coronal T2 WI-STIR) sequence scanning. There were 3 cases scanned on a 1.5 T Avanto scanner and 18 cases with Spectra 3.0 T MRI. Results Out of 21 cases of AT rupture(19 males and 2 females), complete rupture occurred in 20 cases, and partial rupture was in 1 case. There were 14 cases of right AT rupture and 7 cases of left AT rupture. MRI manifestations of AT rupture showed continuous interruption of tendon bundle in 20 cases, partial interruption in 1 case, retraction and deformation of broken end and wavy shape of broken end in 3 cases, horsetail shape in 10 cases, brush shape in 3 cases and pestle shape in 5 cases. The broken end was edematous and filled with blood, showing high signal on MRI, T2 WI and STIR. Coronal STIR showed better morphology of space and edge of AT rupture compared with sagittal STIR. Conclusion MRI can clearly show the morphological structure of achilles tendon and accurately diagnose the location and degree of AT rupture. It can be used as the first choice of imaging examination for AT rupture.