后踝关节撞击综合征患者的磁共振影像学表现分析

Analysis of MRI imaging findings in patients with posterior ankle impingement syndrome

目的 分析110例后踝关节撞击综合征患者的磁共振成像(MRI)影像学表现。方法 选取2020年4月至2023年4月信阳一五四医院110例后踝疼痛患者进行回顾性分析,其中后踝综合征患者40例,非后踝综合征患者70例。后踝综合征患者接受手术治疗,2组患者均采用MRI检查。将2组患者急性或反复跖屈史、后踝部外伤史、踝关节活动受限等情况进行对比,将后踝综合征患者和非后踝综合征患者MRI扫描特征进行对比,分析MRI扫描特征诊断后踝综合征的临床价值。结果 后踝综合征反复跖屈史的患者占比(62.5%)相较于非后踝综合征组(21.4%)升高,差异有统计学意义(P<0.05);后踝综合征组骨髓水肿、长屈肌(FHL)腱鞘炎、软组织水肿患者占比分别为82.5%、62.5%、90.0%,相较于非后踝综合征患者占比(15.7%、21.4%、14.3%)上升,差异有统计学意义(P<0.05);骨髓水肿诊断后踝综合征的灵敏度、特异度、准确度分别为82.5%、84.3%、83.6%;FHL腱鞘炎诊断后踝综合征的灵敏度、特异度、准确度分别为62.5%、78.6%、72.7%;跗三角骨软组织水肿诊断后踝综合征的灵敏度、特异度、准确度分别为90.0%、85.7%、87.3%。结论 将MRI检查应用于后踝撞击综合征患者中,骨髓水肿、跗三角骨软组织水肿具有较高的诊断价值。

Objective To analyze the magnetic resonance imaging(MRI)findings of 110 patients with posterior ankle impingement syndrome.Methods One hundred and ten patients with posterior ankle pain were all from Xinyang 154th Hospital from April 2020 to April 2023 for retrospective analysis,including 40 patients with posterior ankle syndrome and 70 cases without posterior ankle syndrome.All patients with posterior ankle syndrome were treated with surgery and MRI in both groups.The acute or repeated plantar flexion history,posterior ankle trauma history,and ankle joint limitation were compared between the two groups.The MRI scanning features of patients with posterior ankle syndrome and those without posterior ankle syndrome were compared to analyze the clinical value of MRI scanning features in the diagnosis of posterior ankle syndrome.Results The proportion of patients with recurrent plantar flexor of posterior ankle syndrome(62.5%)was higher than that of the non-posterior ankle syndrome group(21.4%),and the difference was statistically significant(P<0.05).The proportion of bone marrow edema,longor flexor(FHL)tenosynovitis and soft tissue edema in the posterior ankle syndrome group were 82.5%,62.5%,and 90.0%,respectively,which was higher than that in the non-posterior ankle syndrome patients(15.7%,21.4%and 14.3%),and the difference was statistically significant(P<0.05).The sensitivity,specificity,and accuracy of diagnosing post-ankle syndrome with bone marrow edema were 82.5%,84.3%and 83.6%,respectively.The sensitivity,specificity,and accuracy of FHL tenosynovitis were 62.5%,78.6%,and 72.7%,respectively.The sensitivity,specificity and accuracy of soft tissue edema of the tarsal triangle were 90.0%,85.7%,and 87.3%,respectively.Conclusion MRI is of high diagnostic value for bone marrow edema and soft tissue edema of tarsal triangle bone in patients with posterior ankle impingement syndrome.