踝三角韧带的解剖学与影像学研究及其临床应用
发布时间：2019-03-03 09:45
【摘要】： 目的： 通过对踝关节三角韧带的解剖学和影像学研究，观察踝关节三角韧带的形态特点，结合对踝关节三角韧带损伤患者手术治疗和疗效的临床观察，进一步探讨踝关节三角韧带损伤的诊断和治疗。 材料和方法： 1．选用青壮年新鲜小腿—足标本10个，分别固定于用泡沫塑料支架固定，进行MRI扫描，各例标本分别行冠状位、矢状位、横断位SET1W1、T2W1检查，了解踝关节三角韧带的走向、位置及测量踝关节三角韧带的长、宽、厚。 2．用同一青壮年新鲜小腿—足标本10个，解剖后行大体解剖观察，了解踝关节三角韧带的走向、位置，用游标卡尺测量踝关节三角韧带的长、宽、厚。 3．临床20例三角韧带断裂的病人，8例行应力试验X光平片、CT和MRI检查与手术后结果的比较，以探讨评价应力试验X光平片、CT，MRI和关节镜对踝关节三角韧带损伤的诊断价值。 结果： 1．标本上的测量踝关节三角韧带的长、宽、厚的数值与在MRI上的测量数值比较，，差异均无显著性。 2．胫距前韧带、胫舟韧带及跟胫韧带在核磁共振(MRI)T1W1上均呈低信号，胫距前韧带冠状面经内踝前层面，横断面经胫距关节平面均能较好显示。胫舟韧带在冠状面经内踝前层面，横断面经距骨滑车层面能较好显示。跟胫韧带冠状面经内踝尖层面、横断面经内踝尖下方层面显示最好。胫距后韧带信号不均，较粗大，其间夹杂高信号的脂肪影，冠状面经内踝中部层面、横断切面经内踝尖层面，显示最好。 3．应力试验X光平片对判断韧带损伤程度有价值，应以健侧作比较，外翻应力下，距骨倾度大于10°则有三角韧带损伤。MRI可直接显示踝关节周围的肌健和韧带，相对常规X线或CT检查来说具有巨大的优势，因此可用于踝关节韧带损伤的诊断。 结论： MRI上的测量数值与解剖学测量的数值基本一致，不同层面不同位置各部分的显示均具有不同的意义。应力试验X光平片是踝关节三角韧带损伤最基本的辅助检查。MRI不仅能检查到韧带损伤，而且能观察到韧带损伤的具体情况和其它潜在的损伤。CT在诊断踝关节三角韧带损伤上并不能提供更多的信息。影像检查只有与临床资料相结合才能提高诊断准确率。
[Abstract]:Objective: to observe the morphological characteristics of the ankle triangular ligament by anatomical and imaging studies, and to observe the clinical observation of the surgical treatment and curative effect of the ankle triangular ligament injury. To further explore the diagnosis and treatment of ankle joint triangular ligament injury. Materials and methods: 1. 10 fresh calf-foot specimens of young adults were fixed with foam scaffolds and scanned by MRI. SET1W1,T2W1 examination was performed on coronal, sagittal and transverse sections of each specimen. To investigate the direction, position and length, width and thickness of ankle triangular ligament. 2. The length, width and thickness of the ankle triangular ligament were measured by Vernier caliper after dissecting 10 fresh calf-foot specimens of the same young and adult, and observing the direction and position of the ankle triangular ligament. 3. The results of stress test X-ray, CT and MRI were compared with post-operative results in 8 of 20 patients with rupture of triangular ligament, in order to explore the evaluation of stress test X-ray plain film, CT,. The value of MRI and arthroscopy in the diagnosis of ankle triangular ligament injury. Results: 1. There was no significant difference between the length, width and thickness of the triangular ligament of the ankle joint measured on the specimen and the measured value on the MRI. 2. The anterior tibialis-talus ligament, the tibial-scaphoid ligament and the calcaneal-tibial ligament showed low signal intensity on the magnetic resonance imaging (MRI) T1W1). The anterior tibial-talar ligament could be displayed on the coronal plane through the medial anterior malleolus plane and the transverse plane through the tibial-talar joint. The tibial scaphoid ligament can be well displayed in coronal plane through medial anterior malleolus plane and cross-sectional transversely talus trochlear plane. The coronal plane of the calcaneal tibial ligament is best displayed through the internal ankle apex, and the cross section through the inferior aspect of the internal ankle tip. The signal of posterior tibiotalar ligament was uneven and thicker, with high signal fat shadow in between, coronal plane through middle of medial malleolus plane, transverse section of posterior tibial ligament through medial ankle apical plane, it was best to show it in the middle plane of medial malleolus. 3. The X-ray plain film of stress test is valuable in judging the degree of ligament injury, and should be compared with the healthy side. Under the overturning stress, the injury of triangular ligament can be found if the tilting degree of talus is more than 10 掳. MRI can directly show the muscles and ligaments around the ankle joint. It has great advantages over conventional X-ray or CT, so it can be used in the diagnosis of ankle ligament injury. Conclusion: the measured values on MRI are basically the same as those measured by anatomy, and the display of different parts on different planes and different positions has different significance. Stress test X-ray plain film is the most basic auxiliary examination of ankle joint triangular ligament injury. MRI can not only detect ligament injury, The specific condition of ligament injury and other potential injuries can be observed. Ct can not provide more information in the diagnosis of ankle triangular ligament injury. Only the combination of imaging and clinical data can improve the accuracy of diagnosis.
【学位授予单位】：同济大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322;R687.2
本文编号：2433588
[Abstract]:Objective: to observe the morphological characteristics of the ankle triangular ligament by anatomical and imaging studies, and to observe the clinical observation of the surgical treatment and curative effect of the ankle triangular ligament injury. To further explore the diagnosis and treatment of ankle joint triangular ligament injury. Materials and methods: 1. 10 fresh calf-foot specimens of young adults were fixed with foam scaffolds and scanned by MRI. SET1W1,T2W1 examination was performed on coronal, sagittal and transverse sections of each specimen. To investigate the direction, position and length, width and thickness of ankle triangular ligament. 2. The length, width and thickness of the ankle triangular ligament were measured by Vernier caliper after dissecting 10 fresh calf-foot specimens of the same young and adult, and observing the direction and position of the ankle triangular ligament. 3. The results of stress test X-ray, CT and MRI were compared with post-operative results in 8 of 20 patients with rupture of triangular ligament, in order to explore the evaluation of stress test X-ray plain film, CT,. The value of MRI and arthroscopy in the diagnosis of ankle triangular ligament injury. Results: 1. There was no significant difference between the length, width and thickness of the triangular ligament of the ankle joint measured on the specimen and the measured value on the MRI. 2. The anterior tibialis-talus ligament, the tibial-scaphoid ligament and the calcaneal-tibial ligament showed low signal intensity on the magnetic resonance imaging (MRI) T1W1). The anterior tibial-talar ligament could be displayed on the coronal plane through the medial anterior malleolus plane and the transverse plane through the tibial-talar joint. The tibial scaphoid ligament can be well displayed in coronal plane through medial anterior malleolus plane and cross-sectional transversely talus trochlear plane. The coronal plane of the calcaneal tibial ligament is best displayed through the internal ankle apex, and the cross section through the inferior aspect of the internal ankle tip. The signal of posterior tibiotalar ligament was uneven and thicker, with high signal fat shadow in between, coronal plane through middle of medial malleolus plane, transverse section of posterior tibial ligament through medial ankle apical plane, it was best to show it in the middle plane of medial malleolus. 3. The X-ray plain film of stress test is valuable in judging the degree of ligament injury, and should be compared with the healthy side. Under the overturning stress, the injury of triangular ligament can be found if the tilting degree of talus is more than 10 掳. MRI can directly show the muscles and ligaments around the ankle joint. It has great advantages over conventional X-ray or CT, so it can be used in the diagnosis of ankle ligament injury. Conclusion: the measured values on MRI are basically the same as those measured by anatomy, and the display of different parts on different planes and different positions has different significance. Stress test X-ray plain film is the most basic auxiliary examination of ankle joint triangular ligament injury. MRI can not only detect ligament injury, The specific condition of ligament injury and other potential injuries can be observed. Ct can not provide more information in the diagnosis of ankle triangular ligament injury. Only the combination of imaging and clinical data can improve the accuracy of diagnosis.
【学位授予单位】：同济大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322;R687.2
【引证文献】
相关硕士学位论文 前1条
1 张玮炜;Maisonneuve 骨折的治疗研究[D];延边大学;2011年
本文编号：2433588
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