踝管腱鞘囊肿MRI评价

Application value of MRI in ganglion cyst in tarsal tunnel

目的 探讨踝管腱鞘囊肿的MRI影像学特征,对胫神经或其分支卡压的观察,以提高MRI诊断正确性。方法 选取分析经手术病理证实13例踝管腱鞘囊肿的临床和MRI资料,包括病变大小、边缘、形态、内部信号特点、强化方式等,并对卡压神经进行评估。观察10例健康志愿者踝管影像解剖结构。结果 13例踝管腱鞘囊肿,呈单房或多房,与周围骨骼肌相比,T1WI表现为稍低、等信号,脂肪抑制T2WI/质子密度加权像(PDWI)表现为明显高信号,囊壁及分隔在T1WI、脂肪抑制T2WI/PDWI表现为明显低信号。11例囊壁光整、菲薄,2例囊壁增厚、毛糙,周围少许渗出性改变。9例出现胫神经血管束受压、移位,6例出现神经肿胀,2例出现去神经肌水肿,1例肌萎缩。10例健康志愿者均可在MRI清楚显示踝管解剖结构。结论 MRI能够在术前对踝管腱鞘囊肿做出准确诊断,并能对神经卡压进行初步评估。

Objective To explore the MRI features of ganglion cyst in tarsal tunnel and to observe the compression of tibial nerve or its branches, in order to improve the diagnostic accuracy of MRI. Methods The clinical and MRI data of 13 cases of ganglion cyst in tarsal tunnel confirmed by operation and pathology were retrospectively analyzed, including the size, margin, shape, internal signal characteristics, enhancement methods, and the evaluation of the entrapment nerve. Anatomical structure of tarsal tunnel was observed in 10 healthy volunteers. Results Thirteen cases of ganglion cyst showed single or multiple room. The weights of T1WI were slightly low or equal signal. The weights of fat-suppressed T2WI/PDWI were obviously high signal. The wall and septum of the cyst showed obvious low signal on T1WI and fat-suppressed T2WI/PDWI. The cystic walls were smooth and thin in 11 cases, thickened and rough in 2 cases, with a little exudative changes around them. 9 cases had tibial nerve vascular bundle compression and displacement, 6 cases had nerve swelling, 2 cases had denervated muscle edema, and 1 case had muscle atrophy. Anatomical structure of tarsal tunnel could be clearly displayed on MRI in 10 healthy volunteers. Conclusion MRI can accurately diagnose ganglion cyst in tarsal tunnel before operation and evaluate nerve entrapment.