High-resolution 3.0T magnetic resonance imaging in diagnosis of ligament and tendon injuries of the forefoot / 中华全科医师杂志

ABSTRACT

Objective:To evaluate the application high-resolution 3.0-T magnetic resonance imaging (MRI) in diagnosis of ligament and tendon injuries of the forefeet.Methods:From September 2014 to August 2020, 40 patients with forefeet injury (40 forefoot) and 20 healthy subjects (40 forefoot) meeting the including and excluding criteria were enrolled into this retrospective study. All subjects underwent MRI T1-weighted image (T1WI) and fat suppression proton density-weighted imaging (PD-FS) scan on coronal planes, sagittal planes and axial planes, respectively. Then the MRI characteristics of tendons in forefoot of healthy subjects and patients with forefoot injuries were compared. In patients the MR features of ligament and tendons injury were compared with the surgical findings or follow-up results.Results:In 20 normal subjects the tendons and ligament of the forefoot showed homogeneous low-signal-intensity on T1WI and PD-FS images. In the 40 patients with forefoot injuries, 22 cases were confirmed by surgical findings and 18 cases were confirmed by follow-up results. There were 8 cases of collateral ligament injuries, including 2 cases with complete tear, 3 cases with partial tear and 3 cases with sprain; 2 cases of extensor tendon with partial tear; 8 cases of flexor tendon injuries, including 3 cases with complete tear, 3 cases with partial tear and 2 cases with sprain; 3 cases of abductor tendon with partial tear; 13 cases of plantar plate injuries; and 6 cases of Lisfranc ligament injuries including 5 cases with complete tear and 1 case with partial tear. The injured ligament and tendons presented thicker and discontinuity in T1WI; and demonstrated heterogeneously increased signal intensity with edema in the surrounding soft tissues in PD-FS. The partially torn ligament and tendons showed discontinuity and thickening; and the completely torn ligament and tendons showed that they were interrupted and retracted, fiber structure disappeared and was filled with liquid, and edema in the surrounding soft tissue.Conclusion:High resolution magnetic resonance imaging of the forefoot can demonstrate the anatomy and features of ligament and tendon injuries in forefoot accurately, which has clinical application value for the early diagnosis and accurate treatment of the injury.