| 吕喆,龚雄辉,哈婷婷,张滨,王娟,年娇.糖尿病足患者足底神经CT形态特点及其临床意义[J].中国医学影像技术,2018,34(6):919~923 |
| 糖尿病足患者足底神经CT形态特点及其临床意义 |
| CT morphological characteristics of plantar nerves and their significances in diabetic foot |
| 投稿时间：2017-07-24 修订日期：2018-03-13 |
| DOI：10.13929/j.1003-3289.201707106 |
| 中文关键词: 糖尿病足 周围神经病变 足底神经 体层摄影术,X线计算机 |
| 英文关键词:Diabetic foot Peripheral neuropathy Plantar nerve Tomography, X-ray computed |
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| 中文摘要: |
| 目的 分析前交叉韧带（ACL）重建术后所致滑膜增厚的关节病变，比较关节感染与粘连的MRI征象差异。方法 回顾性分析25例ACL重建术后滑膜增厚患者临床及MRI资料，诊断均经关节镜等检查证实，其中11例关节感染，14例关节粘连，与首次关节镜下ACL重建术的时间间隔分别为0.3~2.5个月、6~19个月。结果 MRI滑膜增厚病变分别为关节感染和关节粘连。关节感染MRI征象除滑膜增厚外，还可见关节中至大量积液、软组织不同程度肿胀、股骨远端及胫骨近端骨髓水肿、ACL假体纤维连续（5例表现为信号增高）以及骨道假性增宽（5例）。术后关节粘连MRI征象除滑膜增厚外，还可见部分增厚滑膜内见条带状短T2信号，主要累及髌上囊、内外侧隐窝、髌下脂肪垫、髁间窝等部位，关节无或仅见少量积液，ACL假体均连续，3例表现为假体信号增高、边缘毛糙，骨道均无明显增宽。在关节感染与关节粘连间，关节积液、软组织肿胀、骨髓水肿、骨道假性增宽各征象差异有统计学意义（P均<0.05）。结论 关节感染主要表现为滑膜增厚、关节积液，关节腔呈高信号，而关节粘连表现为滑膜增厚、关节腔呈等/稍高信号；关节感染主要发生于术后早期，关节粘连主要发生于术后中晚期。 |
| 英文摘要: |
| Objective To analyze CT morphologicl characteristics of tibial nerve, lateral and medial plantar nerves and their clinical significances in the diabetic foot (DF) patients. Methods Bilateral feet (DF group) of 33 patients diagnosed as type 2 diabetes mellitus with DF were examined with CT. Meanwhile, 36 uninjured feet (NDF group) of patients with single-side foot wound were taken as the controls. CT findings of distal part of tibial nerve, medial plantar nerve and lateral plantar nerve on the same plane were observed with CT post-processing technique. The morphological measurements were done at the points of A1 (tibial nerve measuring position), A2 (proximal part of medial plantar nerve measuring position), A3 (distal part of medial plantar nerve measuring position) and A4 (lateral plantar nerve measuring position). Both of the anteroposterior and transverse diameters were measured and compared between DF and NDF groups. Results Plantar nerves (tibial nerve, medial plantar nerve and lateral plantar nerve) of DF patients were thick (52/66, 78.79%), and the edges of nerve were indistinct (51/66,78.78%). The anteroposterior and transverse diameters of measurement points A1, A2 and A4 in DF group were larger than those in NDF group (all P<0.01). There was no statistical difference of the anteroposterior and transverse diameters of point A3 between the two groups (both P>0.05). Conclusion The plantar nerves of DF patient were thick with indistinct edges. The observation of continuous morphological characteristics and the diameter measurements of the plantar nerve can be performed with CT post-processing technique, which can provide more information for clinical diagnosis of DF. |
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