摘要
目的 探讨Maisonneuve骨折 (MFF)骨间膜损伤及损伤范围的MRI表现。方法 12例急诊收治的MFF患者术前进行MRI检查。采用膝关节线圈对小腿全长分 2段进行检查以获得骨间膜全长的图像。采用轴面T1WI(TR 5 0 0ms,TE 40ms)、T1脂肪抑制 (STIR)像、T2 WI(TR 30 0 0～ 40 0 0ms,TE 180～ 2 0 0ms) ,3例行双侧对比 ,5例术中探查骨间膜。结果 12例患者均存在骨间膜部分断裂 ,断裂范围从胫距关节面最高点到其以上的 32～ 112mm ,平均 79mm ,其近端骨间膜保持完整。 12例患者高位腓骨骨折处的骨间膜均保持完整。 3例行双侧对比 ,显示正常骨间膜起于胫距关节面最高点以上 2 8mm处。与 5例手术结果比较 ,MRI正确诊断 4例。结论 (1)MFF患者都有骨间膜损伤 ,但仅为小腿远端 1/ 3水平以下的部分断裂 ,并未达到高位腓骨骨折水平。近端腓骨骨折处骨间膜均保持完整。 (2 )轴面T1STIR像可显示骨间膜的解剖结构和断裂情况 ,T2 WI可以显示骨间膜损伤引起的出血和水肿。
Objective To study the injury of interosseous membrane ( IOM) in Maisonneuve fracture (MFF) by MRI and to elucidate the extent of the injury. Method Twelve patients with MFF were examined by MRI before operation. MRI examination of the leg was performed with knee coil in 2 steps to get the whole image of IOM.Using axial scan, T 1(TR 500/TE 40 ms),T 1STIR, and T 2WI sequence were performed. The asymptomatic side was also examined in 3 patients to get the comparison. Detection of IOM was done during operation in 5 patients. Result IOM was ruptured in a range of 32-112 mm,with the average length of 79 mm proximal to the talar dome in all of 12 patient. IOM remained intact at the level of proximal fibula fracture. IOM usually originated at the site 28 mm proximal to the talar dome. IOM rupture was found in all 5 patients during operation, the range in 4 coincide with MRI findings (80%). Conclusion IOM rupture was found in all MFF patients. The range of IOM injury in MFF was only below the distal 1/3 of leg,not consistent with the proximal fibula fracture. IOM was intact at the level of proximal fibula fracture. Anatomy and rupture of IOM were clearly visualized with T 1 STIR sequence,while hemorrhage and edema would be better seen on T 2WI.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2000年第6期389-392,共4页
Chinese Journal of Radiology
关键词
磁共振成像
踝关节骨折
骨间膜断裂
Fracture
Magnetic resonance imaging
Fibula
Ankle joint
Dislocations
