【摘要】：目的 觀察、分析臨床診斷的跗骨竇綜合征患者及正常志愿者踝關(guān)節(jié)X線、MSCT及MRI的影像學(xué)表現(xiàn)，探討對(duì)跗骨竇綜合征的診斷有指導(dǎo)價(jià)值的影像學(xué)檢查方法，，為臨床診斷提供更為可靠依據(jù)。 材料與方法 根據(jù)Brown早期提出的診斷標(biāo)準(zhǔn)，收集2010年2月至2011年2月在泰山醫(yī)學(xué)院附屬醫(yī)院臨床診斷為跗骨竇綜合征患者68例和正常志愿者50例，所有病例均先行普通X線檢查，明確足踝部骨質(zhì)有無(wú)明顯骨折，然后行CT和MRI檢查，然后運(yùn)用CT后處理技術(shù)重建出跗骨竇的立體解剖結(jié)構(gòu)及韌帶最大走行層面，分別測(cè)出跗骨竇的容積及韌帶的各徑線的數(shù)值；在不同檢查方法上觀察跗骨竇內(nèi)各種組織的變化，并進(jìn)行統(tǒng)計(jì)學(xué)分析；觀察跗骨竇及其周圍軟組織和骨組織的MRI表現(xiàn)；在CT、MRI圖像上對(duì)照分析跗骨竇綜合征患者與正常志愿者的跗骨竇區(qū)的影像表現(xiàn)；分析跗骨竇綜合征患者跗骨竇區(qū)的CT、MRI圖像各自的特征，尋找最佳的影像學(xué)檢查方法。 結(jié)果 (1)68例臨床診斷為跗骨竇綜合征患者在MRI圖像上出現(xiàn)跗骨竇周圍軟組織信號(hào)異常的有58例，其中韌帶損傷程度包括：Ⅰ°輕微韌帶損傷（32例）；Ⅱ°韌帶不完全斷裂（18例）；Ⅲ°韌帶完全撕裂（3例）；而正常志愿者組未發(fā)現(xiàn)在跗骨竇區(qū)出現(xiàn)軟組織異常信號(hào)。（2）68例臨床診斷為跗骨竇綜合征患者在CT圖像上顯示跗骨竇區(qū)骨質(zhì)有異常41例，包括陳舊性骨折X例，骨關(guān)節(jié)退行性表現(xiàn)X例，而正常志愿者組僅有5例，（3）跗骨竇綜合征患者組磁共振圖像上顯示軟組織較CT圖像清晰，某些退行性表現(xiàn)如關(guān)節(jié)下囊變較清晰；在CT圖像上骨組織顯示較軟組織顯示清晰。(4)跗骨竇綜合征的患者有32例患者的跗骨竇容積變小，主要出現(xiàn)在早期跗骨竇區(qū)骨折治療不當(dāng)和老年患者關(guān)節(jié)發(fā)生退行性變。 結(jié)論 通過(guò)對(duì)患者和志愿者行矢狀位、冠狀位、橫軸位及斜冠狀位的MRI掃描及MSCT掃描的圖像對(duì)比，MRI能夠更好地描述跗骨竇及其周圍解剖結(jié)構(gòu)的改變包括韌帶、正常脂肪組織等改變，而CT能更好的描述骨質(zhì)的情況；多層螺旋CT的3D重建技術(shù)能直觀地顯示足踝部的解剖位置關(guān)系。
[Abstract]:Objective to observe and analyze the imaging features of ankle joint X-ray, MSCT and MRI in patients with tarsal sinus syndrome and normal volunteers, and to explore a valuable imaging method for the diagnosis of tarsal sinus syndrome. It provides a more reliable basis for clinical diagnosis. Materials and methods according to the early diagnostic criteria of Brown, 68 patients with tarsal sinus syndrome and 50 normal volunteers were clinically diagnosed as tarsal sinus syndrome in the affiliated Hospital of Taishan Medical College from February 2010 to February 2011. All cases were examined by general X-ray to determine whether there were obvious fractures of foot and ankle, then CT and MRI were performed, and then the stereoscopic anatomical structure of tarsal sinus and the maximum walking plane of ligaments were reconstructed by CT post-processing technique. The volume of tarsal sinus and the diameter of ligament were measured respectively. The changes of various tissues in tarsal sinus were observed and analyzed statistically, and the MRI findings of tarsal sinus and its surrounding soft tissue and bone tissue were observed. The imaging features of tarsal sinus region in patients with tarsal sinus syndrome and normal volunteers were compared and analyzed on CT,MRI images, and the characteristics of CT,MRI images in tarsal sinus region in patients with tarsal sinus syndrome were analyzed in order to find the best imaging method. Results (1) there were 58 cases of abnormal soft tissue signal around tarsal sinus on MRI images in 68 patients with tarsal sinus syndrome. The degree of ligament injury included: I 擄slight ligament injury (32 cases); Incomplete rupture of 鈪

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