踇长屈肌肌腱腱鞘囊肿的临床及MRI评价

Clinical and MRI evaluation of ganglion cysts around the flexor hallucis longus tendon

摘要:

要 目的 探讨踇长屈肌肌腱腱鞘囊肿的MRI表现及临床意义。方法 回顾性分析我院2018年12月至2021年12月符合19例踇长屈肌肌腱腱鞘囊肿患者临床资料，包括男性12例，女7例；年龄38～64岁，平均51.83岁。左侧8例，右侧11例。所有患者均行MRI检查矢状位T1WI、矢状位及冠状位PDWI抑脂、横断位T2WI抑脂扫描。观察指标包括：①囊肿的位置及范围。②囊肿的信号特征。③关节软骨退变Recht分级。结果:①本研究19例患者中，踝管近端囊肿8例（42.11%），最长径4～8cm，平均为6.41 cm。踝管远端囊肿6例（31.57%），最长径2～6cm，平均为4.05 cm。跖趾关节囊肿5例（26.32%），最长径2.5～3.4cm，平均2.96cm。②MRI表现为关节周围呈边缘光滑肿块，T1 WI为低信号或中等信号，T2 WI或PDWI为高信号。③踝关节或跖趾关节存在显著的退行性改变，Recht关节软骨分级为Ⅲ级—Ⅳ级。结论：MRI能够显示踇长屈肌腱腱鞘囊肿的范围、解剖关系及周围关节退变情况，为临床采取正确的治疗方案提供帮助。

Abstract:

Abstract Objective To investigate the clinical and MRI features of ganglion cysts around the flexor hallucis longus tendon. Methods From December 2018 to December 2021, 19 cases with flexor longus tendon sheath cyst were retrospectively analyzed, including 12 males and 7 females, with an average age of 51.83 years (range, 38-64 years). There were 8 cases on the left side and 11 cases on the right side. All patients were examined by MRI, sagittal T1WI, sagittal and coronal PDWI and transverse T2WI.The observation indexes included: ① the location and range of cyst. ② The signal characteristics of the cyst. ③ Recht classification of articular cartilage degeneration.Results:① Among the 19 cases, 8 cases (42.11%) were Supramalleolar canal, the longest diameter was 4-8 cm, with an average of 6.41 cm. There were 6 cases (31.57%) of inframalleolar canal, the longest diameter was 2-6cm, the average was 4.05cm. And 5 cases (26.32%) with around the metatarsophalangeal joint,the longest diameter was 2.5-3.4cm, with an average of 2.96cm.② MRI showed a smooth border mass around the joint, with low or moderate signal on T1WIand high signal on T2WI and PDWI.③ There were significant degenerative changes in ankle joint or interphalangeal joint, and Recht articular cartilage grade was grade III-IV.Conclusions: MRI could show the range, anatomic relationship and joint degeneration around the ganglion cysts, and provide help for clinical treatment.