母长屈肌腱鞘囊肿的MRI评估

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

摘要:

[目的] 探讨母长屈肌肌腱腱鞘囊肿的MRI 表现及意义。[方法] 回顾性分析本院2018 年12 月—2021 年12 月19例母长屈肌肌腱腱鞘囊肿患者的临床资料，观察囊肿位置及范围、信号特征及软骨退变情况。[结果]19 例患者中，踝管近端囊肿8 例（42.1%），最长径4~8 cm。踝管远端囊肿6 例（31.6%），最长径2~6 cm。跖趾关节囊肿5 例（26.3%），最长径2.5~3.4 cm。MRI 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。19 例患者中15 例存在明显的邻近关节退变，其中11 例在关节周围形成骨赘，9 例出现软骨下骨硬化，4 例存在干骺端的骨髓水肿。13 例患者关节软骨退变，参照Re-cht 分级标准，共涉及67 个关节软骨面，其中5 个关节软骨面为I 级，18 个为II 级，其余关节软骨面均出现III 级或IV 级改变。[结论] MRI 能够显示母长屈肌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:

[Objective] To investigate the clinical and MRI features of ganglion cysts around the flexor hallucis longus tendon. [Meth-ods] From December 2018 to December 2021, 19 patients who suffered flexor longus tendon sheath cyst were retrospectively analyzed, in-cluding 12 males and 7 females, 8 cases on the left side and 11 cases on the right side. All patients were examined by MRI, including sagittalT1WI, sagittal and coronal PDWI and transverse T2WI. The observation data were evaluated, involving the location and range of cyst, the sig-nal characteristics of the cyst and articular cartilage degeneration. [Results] Of the 19 patient, 8 (42.1%) had the cyst found superior to themalleolar canal with longitudinal diameter from 4 to 8 cm, while 6 (31.6%) were distal to the malleolar canal with longitudinal diameter from2 to 6 cm, and 5 (26.3%) had the cyst around the metatarsophalangeal joint with longitudinal diameter from 2.5 to 3.4 cm. In term of MRIcharacteristics, the cyst presents a smooth border mass around the joint, with low or moderate signal on T1WI, whereas high signal on T2WIand PDWI. In addition, 15 of them got significant adjacent joint degeneration, including 11 of periarticular osteophytes, 9 of subchondral os-teosclerosis, and 4 of metaphyseal bone marrow edema. Furthermore, 13 patients had articular cartilage degeneration involving a total of 67articular cartilage surfaces, according to the Recht criteria, 5 articular cartilage surfaces of grade I, 18 of grade II, and the rest articular carti-lage surfaces of grade III or IV changes. [Conclusion] MRI could show the range, anatomic relationship and joint degeneration around theganglion cysts, and provide help for clinical treatment.