利斯弗朗克复合体的正常反侧变化和微妙不稳定性的诊断截止值使用3D承重CT
Alexandra Flaherty1, Noopur Ranganathan1, Gregory Waryasz1,2
1Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Foot & ankle international
|December 17, 2025
概括
负载计算断层扫描 (WBCT) 显示了显著的Lisfranc不稳定性变化. 扩散测量为识别Lisfranc损伤提供了最高的诊断准确度.
科学领域:
- 整形外科 整形外科 整形外科
- 放射学 放射学是一门学科.
- 生物力学 生物力学
背景情况:
- 承重计算断层扫描 (WBCT) 通过在生理负荷下比较受伤和未受伤的四肢,允许动态的足部评估.
- 了解Lisfranc复合体中的正常3D WBCT变异对于诊断不稳定性至关重要.
研究的目的:
- 在健康个体中建立3D WBCT Lisfranc变异.
- 为了确定WBCT测量截止值来诊断Lisfranc不稳定性.
主要方法:
- 对222名双边脚WBCT扫描的成年患者进行了回顾性分析.
- 测量了Lisfranc复杂体积,轴面积和宽度,并计算了对侧脚之间的百分比差异.
- 接受器运营商曲线下的面积 (AUC) 分析用于确定诊断截止值.
主要成果:
- 在Lisfranc不稳定和对照组的患者之间观察到WBCT测量的显著差异 (P < .001).
- 确定了诊断的截止值:体积为20%,面积为26%,扩散为34%.
- 透析表现出最高的诊断性能 (AUC = 0.905),灵敏度为0.813和特异性为0.900.
结论:
- 在健康个体中,对侧脚之间的生理差异通常高达12%.
- 里斯弗朗克不稳定病例的中位数百分比差异≥32%.
- 扩散测量为孤立的Lisfranc不稳定性提供了最高的诊断准确性,截止值为34%.
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