摘要
目的探讨MRI在婴幼儿先天性马蹄内翻足(CCF)中的应用价值。方法收集2周岁以下12例婴幼儿CCF行双足冠状位、横截面、矢状位MRI检查。观察CCF和正常足冠状位、矢状位的距跟角和胫跟角及距、跟、舟状骨及软骨结构的发育情况。结果正常足冠状位、矢状位的距跟角和胫跟角均值分别为38.4°、36.6°、13.9°、73.4°。婴幼儿CCF冠状位,矢状位的距跟角和胫跟角均值分别为15.2°、14.5°、2.2°、102.1°。CCF的矢状位、冠状位距跟角明显小于正常足。CCF矢状位胫跟角大于健侧,冠状位胫跟角小于健侧,有统计学意义。CCF的MRI影像表现有:①骨性改变:跗骨本身的畸形,主要在距骨。跗骨各骨力线异常。部分患儿距舟关节脱位;②软骨改变:距骨骨化中心比正常小,发育滞后,骨核中心偏心,位置偏向内侧。距、跟骨纵径较正常小。结论MRI可直接详细了解CCF的病理改变,判断CCF的软骨变化。MRI是临床评价婴幼儿CCF骨、软骨结构和重要软组织的有效方法,是治疗和随访婴幼儿CCF的一种良好手段。
Objective To evaluate the application of MRI in infantile congenital clubfoot. Methods Twelve patients （7 boys and 5 girls;Age range from 5 months to 24 months, mean 12 months） diagnosed CCF by clinical characters, included 8 unilateral clubfeet and 4 bilateral clubfeet. The true transverse, sagittal and coronal images were taken in all patients. Talocalcaneal and tibiocalcaneal angle in the sagittal and coronal images were measured. Results The average value of talocalcaneal and tibiocalcaneal angle of the normal feet were 36. 6°, 73. 4° respectively in the sagittal images and 38. 4°, 13. 9° in the coronal images; those of the CCF were 14. 5°, 102. 1°, 15.2° and 2. 2°. There were significant differences between clubfeet and normal feet. The MRI manifestations of CCF included rotational deviation of talus and calcaneus and a delayed ossification of the navicular and cuboid bones as well as form deviations in the talus. The development of ossification center was more delayed compared with normal feet, and ossification position was often deformed, small, and eccentrically located, especially in the talus. The length of talus and calcaneus was smaller than that in normal feet. Conclusions MRI can clearly visualize both the ossification centers and surrounding cartilage of growing bones. It is a useful imaging modality for assessment of the bony, cartilaginous and soft-tissue structures of the infantile clubfoot and an excellent tool for CCF treatment and follow-up.
出处
《中华小儿外科杂志》
CSCD
北大核心
2007年第10期531-534,共4页
Chinese Journal of Pediatric Surgery
关键词
马蹄内翻足
磁共振成像
Equinovarus
Magnetic resonance imaging
