MRI上距腓前韧带-距腓后韧带角度的增加可能有助于评估慢性踝关节不稳定。

IF 1.2 4区医学 Q3 ANATOMY & MORPHOLOGY Surgical and Radiologic Anatomy Pub Date : 2023-10-01 Epub Date: 2023-07-10 DOI:10.1007/s00276-023-03196-7

Lei Zhang, Ting Lan, Junyao Chen, Zidong Wei, Houyin Shi, Guoyou Wang

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摘要

目的：本研究旨在比较慢性踝关节不稳定（CAI）患者和健康志愿者的距腓前韧带（ATFL）和距腓后韧带（PTFL）角度的差异，以确定ATFL-PTFL角度是否是一种可靠的CAI评估方法，从而提高临床诊断的准确性和特异性。方法：这项回顾性研究包括240名参与者：2015年至2021年间的120名CAI患者和120名健康志愿者。在MRI上测量两组患者的踝关节区域的ATFL-PTFL角度。在参与者接受全面的MRI扫描后，ATFL-PTFL角度被视为受伤ATFL患者和健康志愿者的主要指标进行比较，并由经验丰富的肌肉骨骼放射科医生进行测量。此外，本研究还包括了涉及AFTL解剖和形态学特征的其他定性和定量指标，如ATFL的长度、宽度、厚度、形状、连续性和信号强度，这些指标可作为次要指标。结果：在CAI组中，ATFL-PTFL角度为90.8° ± 5.7°，与ATFL-PTFL角度为80.0°的非CAI组有显著差异 ± 3.7°（p 结论：与健康人相比，大多数CAI患者的ATFL-PTFL角度较大，可作为诊断CAI的次要指标。然而，ATFL的MRI特征变化可能与ATFL-PTFL角度的增加无关。

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The increased anterior talofibular ligament-posterior talofibular ligament angle on MRI may help evaluate chronic ankle instability.

Purpose: This study intended to compare the difference between the anterior talofibular ligament (ATFL) and posterior talofibular ligament (PTFL) angle with chronic ankle instability (CAI) patients and healthy volunteers, and to confirm whether using the ATFL-PTFL angle could be a reliable assessment method for CAI, so as to improve the accuracy and specificity of clinical diagnosis.

Methods: This retrospective study included 240 participants: 120 CAI patients and 120 healthy volunteers between 2015 and 2021. The ATFL-PTFL angle of the ankle region was gaged in the cross-sectional supine position on MRI between two groups. After participants undergoing a comprehensive MRI scanning, ATFL-PTFL angles were regarded as the main indicator of patients with the injured ATFLs and healthy volunteers to compare, and were measured by an experienced musculoskeletal radiologist. Moreover, other qualitative and quantitative indicators referring to anatomical and morphological characteristics of the AFTL were included in this study with MRI, such as the length, width, thickness, shape, continuity, and signal intensity of the ATFL, which can be used as secondary indicators.

Results: In the CAI group, the ATFL-PTFL angle was 90.8° ± 5.7°, which was significantly different from the non-CAI group where the ATFL-PTFL angle for 80.0° ± 3.7° (p < 0.001). As for the ATFL-MRI characteristics, the length (p = 0.003), width (p < 0.001), and thickness (p < 0.001) in the CAI group were also significantly different from the non-CAI group. Over 90% of the cases, patients of the CAI group had injured ATFL with an irregular shape, non-continuous, and high or mixed signal intensity.

Conclusion: Compared with healthy people, the ATFL-PTFL angle of most CAI patients is larger, which can be used as a secondary index to diagnose CAI. However, the MRI characteristic changes of ATFL may not relate to the increased ATFL-PTFL angle.

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来源期刊

Surgical and Radiologic Anatomy ANATOMY & MORPHOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.70

自引率

14.30%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.