摘要目的：探讨应用MR、CT和X线检查显示距跟骨间韧带( ITCL)及其所在间隙的可行性及可比性。方法回顾性分析2008年2月—2010年3月在河北医科大学第三医院创伤急救中心行足部MRI检查且足踝部无创伤史的41例患者(82侧足)的影像资料,其中男26例、女15例,年龄平均43(27~70)岁,身高平均167(152~185)cm；另选取30名志愿者行足部CT和X线检查,男女各15名,年龄平均23(21~24)岁,身高平均170(142~187)cm。分别行MR和CT扫描,行矢状面和斜冠状面重建,在重建图像上测量ITCL及其间隙的长度。行足侧位X线摄像,设定球管向肢体近端偏转为尾侧投照,向肢体远端偏转为头侧投照,依次自尾侧15°、10°、5°,中立位,头侧5°、10°、15°进行投照。选出清晰显示ITCL间隙及其跟骨侧和距骨侧界线的最佳图像,测量ITCL间隙长度,并与MRI和CT矢状位图像上对应的长度比较。结果在MRI或CT矢状面和斜冠状面上,ITCL长度或其间隙长度在同性别左、右侧间无明显差异,同侧别男性大于女性；同性别矢状面上长度小于斜冠状面上长度。在MRI矢状面图像上ITCL平均长度男性为13.1 mm,女性为12.2 mm；斜冠状面图像上ITCL平均长度男性为14.7 mm,女性为13.7 mm。在 CT 矢状面图像上 ITCL 间隙平均长度男性为13.1 mm,女性为12.3 mm；斜冠状面图像上ITCL间隙平均长度男性为14.7 mm,女性为13.8 mm。不同投照角度 X 线片中,头侧10°片显示跗骨窦及 ITCL 间隙清晰, ITCL 间隙平均长度男性为13.1 mm,女性为12.4 mm。结论头侧10°投照足侧位X线是显示ITCL间隙的最佳位置,ITCL间隙长度与CT和MRI矢状面图像上对应长度具有可比性。

abstractsObjective To explore the feasibility and comparability of MR, CT scan and radiograph in demonstrating the interosseous talocalcaneal ligament ( ITCL ) and the gap where the ligament lies. Methods The data of 41 cases admitted in the Third Hospital of Hebei Medical University from February 2008 to May 2010 were retrospectively studied. In 41 cases, male/female was 26/15, average age was 43 years(27-70)years, average height was 167 cm(152-185)cm. CT scan and X-ray film were performed on 30 healthy volunteers. In 30 cases, male/female were 15/15, average age was 23(21 -24) years old, average height was 170(142-187)cm. MRI and CT scans of the ankle and foot were taken on the objects without trauma or injury in the ankle and foot, respectively. The sagittal and oblique coronal planes of MR and CT images were reconstructed, and the ITCL length was measured in the reconstructed images. Then radiographs of the foot were taken with X-ray beam in various directions. Adjusting the rotation angle, the tube tilted distally was taken as cephalic rotation and the tube tilted proximally was recorded as caudal rotation. Seven radiographs of each foot were taken consecutively at 15, 10, 5 degrees cephalic rotation, neutral position, 5, 10, and 15 degrees caudal rotation. The optimal ITCL gap was observed and measured on each radiograph. The data were compared with those obtained from CT or MR images. Results There was no significant difference between the ITCL lengths either on saggital or oblique coronal CT and MR images between both sides among the same gender. The length for male was longer than that for female on both saggital and oblique coronal CT and MR images. The ITCL length on saggital CT and MR images was shorter than that on oblique coronal CT images. On the saggital MR images, the average length of ITCL was 13. 1 mm for males and 12. 2 mm for females. On the oblique coronal MR images, the average length of ITCL was 14. 7 mm for males and 13. 7 mm for females. On the saggital CT images, the average length of ITCL gap was 13. 1 mm for males and 12. 3 mm for females. On the oblique coronal CT images, the average length of ITCL gap was 14. 7 mm for males and 13. 8 mm for females. The ITCL gap length of the left side was similar to that of right side obtained from the same X-ray beam rotation. The ITCL gap was demonstrated clearly on the 10 degrees cephalic rotation, with an average length of 13. 1 mm for males and 12. 4 mm for females. Conclusions The 10 degrees cephalic rotation lateral radiographs of the foot can clearly demonstrate the gap, on which the gap length measured is not significantly different from the length measured on CT and MR sagittal images.