【2017年整理】踝关正常解剖和损伤性病变的影像表现20160617.pptVIP

胫前、胫后肌腱撕裂 MR表现： 胫骨前肌腱较少发生撕裂，一旦发生，多为全肌腱损伤 胫骨后肌腱出现横截撕裂或纵行撕裂 肌腱增粗，原本椭圆形的肌腱横断面变成圆形 可为横向或纵向撕裂；完全或部分撕裂 相应的腱鞘积液和鞘膜增厚 邻近关节见骨关节炎表现 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 胫前肌腱撕裂 T1WI T2WI Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 跟腱断裂 病因病理机制： 有体育运动史，对抗收缩力的足被动背屈（小腿三头肌群） 常位于跟骨上方2~6cm处发生断裂 类风湿性关节炎、系统性红斑狼疮、糖尿病和痛风 急性断裂：易患因素包括慢性跟腱炎和部分撕裂 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 跟腱断裂 MR表现：（信号+形态） 正常跟腱呈均匀低信号 脂肪抑制T2WI图像上，跟腱内部或跟腱周围软组织出血或水肿表现为信号增高，跟腱断裂/撕裂表现为跟腱连续性中断或不伴波浪状回缩 跟腱近端回缩，跟腱边缘磨损，呈螺旋状形态 撕裂处增粗的近端与远端之间可见疏松的连接 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 跟腱断裂 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 跟腱完全断裂 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 踝关节损伤——肌腱部分、完全撕裂 T2WI显示跟腱增粗，呈混杂信号；周围软组织水肿 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 踝关节撞击综合征 踝关节撞击综合征为在运动时踝关节周围软组织或骨相互撞击、挤压所致造成的疼痛状态。主要表现为踝关节慢性疼痛，过度活动时疼痛加剧。 其病因主要为反复微创伤所致软骨损伤，引起韧带、滑膜炎性增生和骨赘产生，关节活动时增生的滑膜嵌入骨赘中而产生挤压疼痛。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 踝关节撞击综合征 包括骨性撞击和软组织撞击两类。 骨性撞击综合症一般是指距骨和胫骨骨赘之间的撞击。 软组织撞击为关节囊、滑膜、韧带增生、肥厚或瘢痕组织增生所致。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 踝关节正常解剖及损伤性病变的影像表现 赤峰市医院 戴纪男 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 大体解剖与影像解剖 全身第三大持重关节 踝关节包括：胫距关节、