症状型非骨性跟距骨联合患者继发改变的影像学特点分析

·影像诊断·

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【Abstract】 Objective To investigate the MRI characteristics of secondary changes in patients with symptomatic non-osseous talocalcaneal coalition （TCC）.MethodsA retrospective analysis was performed on MRI imagesof 93 symptomatic non-osseous TCC patients treatedat Shanxi Bethune Hospital from January 2019 to December 2O24.Two radiologists reviewed the images on the same PACS workstation to determine the histological type of TCC（classified as fibrous or cartilaginous）and evaluate secondary changes in the surrounding bone and soft tissues.Interobserver agreement for TCC tisse type and secondary changes was assssed using the Kappa test， while differences in secondary changes between tissue types were compared using the chi-square test or Fisher's exact test.ResultsThe secondarychanges observed in 93 non-osseous TCC cases included：Subarticular irregularity，bonemarrow edema，and/orcysticchanges（ n =83， 89.2% ）;Lateraltalardomebonemarrowedema （ n= 8，8.6 % ）;Medialtalardomebonemarrowedema（ n =5， 5.4% ）;Medial/lateralmalleolarbonemarrowedemawith surrounding soft tissue edema （n=57，61.3 % ）;Deltoidligamentinjury/tear （n=37，39.8 % ）; Tarsal tunnel ganglion cysts （ n =22， 23.7% ）; Flexor hallucis longus tendon（FHLT） injury（ n =52，55.9 % ）; Flexor digitorum longus tendon （FDLT） injury（ n =16， 17.2% ）Posterior tibial tendon （PTT）injury（ n =8， 8.6% ）; Medial plantar nerve （MPN） injury（ n= （20 55， 59.1 % ）; Sinus tarsi injury（ n =2， 2.2% ）.No statistically significant differences were found in the incidence of secondary changes between the fibrous（n=2O） and cartilaginous（ n =73）groups（ P>0.05 forall comparisons）. ConclusionThe most common secondary changes in symptomatic non-osseous TCC were subarticular irrgularity， bone marrow edema，and/orcystic changes，followed by medial/lateral malleolar bone marrow edema with surounding soft tissue edema.Additionally，injuries totheMPNandFHLTwithinthetarsaltunnelwerefrequent. Therefore，evaluation of tarsal tunnel contents should be emphasized in symptomatic TCC patients.

【Key words】 Talocalcaneal coalition; Non-osseous coalition； Secondary changes;Imaging examinationDOI：10.19522/j.cnki.1671-5098.2025.11.006

跟距骨联合（talocalcanealcoalition，TCC）是一种先天性足踝畸形，表现为跟骨与距骨之间出现异常连接，根据组织类型可分为骨性、软骨性或纤维性3种类型，多为先天性病变。（剩余7419字）