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目的：探讨Haglund综合征的MRI表现特征及相关参数测量对于诊断的意义。方法：选取2023年1月至2024年7月经临床及MRI综合诊断的100例Haglund综合征患者作为病例组，另选取同期行MRI检查踝关节跟骨无Haglund畸形者100例作为对照组。重点在MRI上观察跟骨的形态学及信号有无异常，跟腱及其周围软组织有无异常。在MRI矢状位T1WI上分别测量两组BRINK角。结果：两组在跟腱跟骨附着处位置差异无统计学意义（P>0.05），病例组较对照组更易于出现跟骨骨髓水肿（23 vs. 4），也更易出现非附着点肌腱病（34 vs. 10）、插入性跟腱病（91 vs. 27）、跟骨后滑囊炎（80 vs. 37）、腱周炎/腱旁炎（44 vs. 16）、跟骨皮下滑囊炎（42 vs. 28）及Kager脂肪垫水肿（39vs. 11），差异均具有统计学意义（P<0.05）。BRINK角在Haglund综合征和对照组的ROC曲线分析，具有显著统计学差异（P<0.0001）,AUC值（95%置信区间）为0.807(0.747,0.866)，分界值为19.19°，诊断Haglund综合征的敏感度为81.00%，特异度为72.00%。结论：MRI易于显示Haglund综合征的跟骨骨髓水肿、跟腱变性或部分撕裂、跟骨后滑囊炎和跟骨皮下滑囊炎以及Kager脂肪垫水肿等特征性影像学表现，MRI测量BRINK角可较好区分是否患有Haglund综合征。
Abstract：Objective: To investigate the significance of MRI performance characteristics and related parameter measurements for the diagnosis of Haglund syndrome. Methods:100 cases of Haglund syndrome diagnosed by clinical and MRI from January 2023 to July 2024 were selected as the case group,and another 100 cases without Haglund deformity examined by MRI during the same period were selected as the control group. Focus on MRI to observe whether there was any abnormality in the morphology and signal of the calcaneus, and whether there was any abnormality in the Achilles tendon and its surrounding soft tissues. The BRINK angles of the two groups were measured on MRI sagittal T1 WI. Results: There was no significant difference between the two groups in the position of Achilles tendon attached to calcaneus(P>0.05). Compared with the control group, the case group was more prone to calcaneus bone marrow edema(23 vs.4), non-attached tendinopathy(34 vs.10), Achille's insertional tendinopathy(91 vs. 27),retrocalcaneal bursitis(80 vs.37), peritendinitis and paratendinitis(44 vs.16), retro-Achilles subcutaneous bursitis(42 vs. 28) and edema of Kager fat pad(39 vs. 11),all were with statistically significant difference(P<0.05).The analysis of ROC curve of BRINK angle between Haglund syndrome and control group showed statistically significant difference(P<0.0001). The AUC value(95% CI) was 0.807(0.747, 0.866),and the cut-off value was 19.19°, and a diagnosis of Haglund syndrome with a sensitivity was 81.00%and specificity was 72.00%. Conclusion: MRI can easily show the characteristic imaging manifestations of Haglund's syndrome such as calcaneal marrow oedema, Achilles tendon degeneration or partial tear, retrocalcaneal bursitis and retro-Achilles subcutaneous bursitis, and Kager's fat pad oedema. MRI measurement of BRINK angle can well distinguish whether Haglund syndrome exists or not.
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基本信息:
DOI：
中图分类号:R686;R445.2
引用信息:
[1]孙惠芳,丁长青,孙迎迎,等.Haglund综合征的MRI表现特征及测量评估[J].影像技术,2025,37(05):16-21.
基金信息:
2023年徐州市推动科技创新专项资金——社会发展基金项目（KC23330）