摘要
目的 探讨踝关节外侧副韧带损 伤MRI特征及治疗后MRI表现,并评价其临 床诊断价值。方法 回顾性分析106例踝关 节外侧副韧带损伤的MRI图像,其中74例 经手术证实,另外32例经临床诊治随访及 MRI复查证实。结果 踝关节外侧副韧带 损伤MRI表现为:Ⅰ度,韧带肿胀,T2WI 上信号增高。轻Ⅱ度与重Ⅱ度:韧带肿胀 或韧带变细,韧带连续性部分中断(轻Ⅱ 度撕裂小于1/2,重Ⅱ度撕裂大于1/2), T2WI信号不均匀增高。Ⅲ度连续性中断, 断口不整齐,关节有较多积液。踝关节外 侧副韧带损伤可以伴随其它损伤。用MRI 对患者进行治疗后的追踪检查,可以采用 0-Ⅲ级标准评价患者治疗效果。结论 MRI 是全面评价踝关节外侧副韧带损伤及治疗 效果的最佳方法,可为临床诊断和治疗提 供充分的资料。
Objective To investigate feature of lateral collateral ankle ligament injury and appearance of post-treatment on MRI, and evaluate its clinical diagnostic value. Methods MRI examinations of 106 cases with lateral collateral ankle ligament injury were retrospectively analyzed. Among all patients, 74 cases were proved by operation, other 32 cases were proved by clinical therapy, follow up and the recovery condition about posttreatment by MRI. Results We can see the appearance of lateral collateral ankle ligament injury on MRI: Grade Ⅰ, the ligaments showed enlargement and hyperintense on T2 wigthed imaging. Grade Ⅱ of slight and severe, the ligaments showed enlargement or diminution, with interruption of partial ligament, s continuity (rupture less than 1/2 on grade Ⅱ of slight, rupture larger than 1/2 on grade Ⅱ of severe), heterogeneous hyperintense on T2 wigthed imaging. Grade Ⅲ, ligaments showed interruption of whole ligament, s continuity, and the broken end show irregular, and the joint have major hydrops. Other injury can be seen with lateral collateral ankle ligament injury. Patients of post-treatment were examined by MRI, we can evaluate therapeutic effect by grade 0-Ⅲ. Conclusion MRI is the best method which comprehensive evaluate therapeutic effect, it can provided full information for clinical diagnosis and treatment.
【关键词】踝关节;外侧副韧带;磁共振成像
【中图分类号】R684
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.01.044
前言
踝关节损伤很常见,Perrich等[1]报道在美国每天大约有1万人损 伤踝关节,而踝关节外侧副韧带损伤又是踝关节损伤中较为常见而又 容易被忽视的损伤。目前研究踝关节外侧副韧带损伤的文献以超声为 主,MRI较少,而国内外尚未见采用MRI观察踝关节外侧副韧带损伤治 疗效果的报道,本文拟通过在本院诊疗的106例踝关节外侧副韧带损伤 患者的MRI资料,总结其MRI对踝关节外侧副韧带损伤及其治疗效果观 察的临床应用价值。
中国CT和MRI杂志
第15卷, 第 1 期
2017年01月
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