摘要目的 研究业余马拉松运动员足损伤的MRI表现及MRI对足损伤的诊断价值.方法于2018年10月至2019年3月间,根据本研究的纳入和排除标准,并在知情同意的情况下,在北京地区招募48名业余马拉松运动员入组.根据入组者足部临床表现,按照足踝损伤程度量表(FASS分级表)进行分级,并行双足MRI检查.研究业余马拉松运动员足部疼痛的MRI表现特点,并将性别、年龄、参加马拉松运动时间、每周跑步量、完成全程马拉松运动次数与足痛症状进行相关性分析.结果 FASS分级0级28侧,其中男8侧、女20侧,第1跖趾关节积液8侧、骨髓水肿6侧、软组织水肿4侧、腱鞘积液4侧、无异常发现6侧;FASS分级1级68侧,其中男42侧、女26侧,跟腱炎38侧、足底筋膜炎14侧、跟腱滑囊炎12侧、后踝撞击综合征4侧.业余马拉松运动员中足部疼痛的发生率与性别相关(OR=1.060,P=0.043),与年龄(OR=0.248,P=0.078)、完成马拉松次数(OR=1.006,P=0.956)、参加马拉松运动时间(OR=1.008,P=0.944)及每周跑步量(OR=0.971,P=0.407)不相关.结论 在业余马拉松运动员中,足痛的主要原因是跟腱和足底筋膜损伤,而无足痛症状者也可有关节积液、腱鞘积液和骨髓水肿等表现.性别是业余马拉松运动员足部疼痛发生率的唯一影响因素.MR检查是明确足损伤的有效方法,在足损伤的诊断和治疗方面具有重要的临床应用价值.

abstractsObjective To study the MRI manifestations of foot injuries in amateur marathoners and the diagnostic value of MRI for foot injuries. Methods Forty?eight amateur marathoners were prospectively recruited from October 2018 to March 2019. Participants were grouped according to the FASS criteria. All participants underwent bilateral foot MRI examinations. The MRI features of foot in amateur marathoners with and without foot pain were analyzed.The association with gender, age, time to participate in marathon, amount of running per week, number of times to complete the whole marathon and the symptoms of foot pain was studied. Results There were 28 sides in FASS in grade 0, including 8 males and 20 females, 8 hydrocele of the first metatarsophalangeal joint, 6 edema of bone marrow, 4 edema of soft tissue, 4 hydrocele of tendon sheath, and 6 without abnormal manifestations of MRI. There were 68 sides in FASS grade 1, including 42 males and 26 females, 38 Achilles tendinitis, 14 plantar fasciitis, 12 Achilles tendon bursitis and 4 posterior ankle impingement syndrome. The incidence of foot pain in amateur marathoners was related to gender(OR=1.060, P=0.043), unrelated to age(OR=0.248, P=0.078), number of marathons completed(OR=1.006, P=0.956), time to participate in marathon(OR=1.008,P=0.944), amount of running per week (OR=0.971,P=0.407). Conclusion Among amateur marathon runners, the foot pain is mainly caused by Achilles tendon and plantar fascia, while those without foot pain are mainly characterized by joint effusion, tendon sheath effusion and bone marrow edema. Gender is the only factor affecting the incidence of foot pain in amateur marathoners. MRI examination is an effective method to determine foot injury and has important clinical application value in the diagnosis and treatment of foot injury.