基于足踝支持带损伤与韧带肌腱损伤关联性的MRI影像诊断研究

MRI Imaging Diagnosis Based On Correlation between Ankle Retinaculum Injury and Ligament Tendon Injury

目的 探讨足踝部支持带损伤与周围韧带肌腱损伤在MRI影像上的关联性表现,包括损伤部位的关联性和损伤程度。方法 对2020年1月-2022年5月足踝损伤58例患者资料进行回顾性分析,将足踝肌腱韧带损伤与相应支持带损伤的关联性进行分组,伸肌支持带损伤组(n=19),屈肌支持带损伤组(n=38),腓侧上下支持带损伤组(n=52),SD值36,均进行MRI常规T1WI、T2WI平扫及PDWI压脂序列扫描,结合患者损伤原因对伸屈肌支持带信号及形态进行分析其损伤情况与足踝部各方位韧带肌腱损伤进行匹配对照其相关性,从而形成支持带损伤数目和程度,与韧带肌腱损伤之间的必然联系。结果 足踝损伤合并腓侧上下支持带损伤约占89.6%,合并屈肌支持带损伤约占65.5%,跟腱损伤伴屈、伸肌支持带损伤分别约占82.6%、90%;距腓前、后韧带损伤伴腓骨上下支持带损伤约占90.9%;踝管损伤伴屈肌支持带约占60.5%。屈、伸肌支持带损伤撕裂伤约占60.5%~89.4%。结论 足踝损伤合并腓侧上下支持带损伤占比最高,其次是屈肌支持带损伤多伴踝管损伤;伸肌上下支持带损伤占比较低,另外跟腱损伤伴屈肌支持带损伤占比最高,距腓前、后韧带损伤伴腓侧上下支持带损伤占比较高;屈伸肌支持带损伤大多为部分撕裂伤。

Objective To explore correlation between MRI imaging of ankle retinaculum injury and peripheral ligament and tendon injury,including correlation of injury site and degree.Methods The paper reviewed and anaylzed data of 58 patients with ankle injury from January 2020 to May 2022,and divided them into three groups based on correlation between ankle tendon and ligament injury and corresponding retinaculum injury:extensor retinaculum injury group(n=19),flexor retinaculum injury group(n=38),fibular superior and inferior retinaculum injury group(n=52),with SD value of 36,with routine MRI scanning of T1WI,T2WI plain scan and PDWI compression sequence.The paper analyzed injury situation based on injury cause,signal and morphology of extensor and flexor retinaculum of patients,and matched ligament and tendon injuries in all directions of ankle and compared their correlation to form inevitable relationship between number and degree of retinaculum injuries and ligament and tendon injuries.Results About 89.6%of ankle injuries were associated with fibular superior and inferior retinaculum,65.5%with flexor retinaculum,82.6%with achilles tendon and 90%with extensor retinaculum respectively;about 90.9%of anterior and posterior peroneal ligament injuries were accompanied by superior and inferior retinaculum injuries of fibula;60.5%had ankle canal injury with flexor retinaculum,60.5%~89.4%had injury and laceration of flexor and extensor retinaculum.Conclusion Ankle injuries combined with fibular superior and inferior retinaculum injuries have the highest proportion,followed by flexor retinaculum injuries accompanied by ankle canal injuries;upper and lower retinaculum injuries of extensor muscle accounts for relatively low proportion.Proportion of achilles tendon injuries with flexor retinaculum is the highest,that of anterior and posterior talofibular ligaments injuries to fibular upper and lower retinaculum is relatively high,and extensor retinaculum injuries were mostly partial lacerations.