MRI Scan Scheme Of Subtalar Joint Ligaments Based On Anatomical Study

Objective :Anatomical observation of the anatomical characteristics of interosseous talocalcaneal ligament(ITCL),cervical ligament(CL)and measure its direction in the three-dimensional space,For the clinical application of MRI diagnosis of ITCL,CL injury to find the best MRI positioning method.Materials and Method:1.Application of 7 cases of ankle on the 15 cm amputation of fresh frozen body specimens,Anatomy of the anterior bundle and posterior bundle of the interosseous talocalcaneal ligament.Application of vernier caliper to measure the length,width and thickness of ligament.Applying the protractor to measure the angle of the ligament with the ankle coronal plane,horizontal plane and other directions.Each measurement was repeated three times and the measured average was recorded.2.Select an adult volunteer with no ankle deformity ? fractures and surgeryhistory.MRI scan was performed at 14 foot.Use of phased array orthogonal limb coil(foot dedicated coil).In the natural neutral position,scan the ankle and its image plane as a base.The angle between the ligaments of the ligament and the ankle joint is the reference angle.Scanning from the interosseous ligament within the tilt sagittal Anterior oblique coronal and external tilt sagittal position,Scanning the cervical ligament of Inclined sagittal and and the oblique coronal position.electroniccaliper,IMPAXsoftwareversion5.2,Agfa Healthcare.Measurementsw ere repeated three times by the same person with1 year of general radiology and 2years of musculoskeletal fellowship and the average values were documented.The thickness and width are converted by the number of layers Thickness 1mm,interval0mmResult:1.Anatomy and measurement results of the cervical ligament and the interosseous talocalcaneal ligament1.1 Anatomy and measurement result of cervical ligamentThe cervical ligament(also called the anterolateral talocalcaneal or the anterior talocalcaneal ligament)is the strongest element connecting the talus and calcaneus.Its origin is delineated by a clearly defined bony eminence located at the antero-in ferior position of the head of the talus(the tuberculum cervicis)stop at the dorsal surface of the anterior calcaneal tubercle.The anatomy of this study found that the ligament was a single bundle,no multiple ligaments.Anatomical measurement of the length,width and thickness of the cervical ligament were 18.43 ± 1.47 mm,9.84 ± 1.41 mm,2.47 ±0.64 mm.The angle between the long axis of the cervical ligament and the horizontal plane of the ankle joint is 43.83 ± 1.65 °.The angle between the direction of the cervical ligament on the calcaneus and the coronal plane of the ankle joint is 61.12 ±2.44 °.The angle between the running direction of the cervical ligament and the oblique coronal plane is 30.29 ± 1.80 °.1.2 Anatomy and measurement result of interosseous talocalcaneal ligament The interosseous talocalcaneal ligament is a flat ligament which arises from the sulcus tali and inserts into the sulcus calcanei.Its fibers are orientated obliquely superomedially.Most of the ligaments are located in the sinuses tarsi,The lateral part is located inside of the tarsal canal.As the tarsal canal oblique to the front of the line so the whole of the ligament is inclined inward.The interosseous talocalcaneal ligament consists of an anterior bundle and a posterior bundle.In the oblique coronal plane on the front beam from the front to back inside the line,The front and posterior bundle are partially crossed,The angle between the posterior bundle and the ankle joint is minimal.The front and rear beams are sagitated on the sagittal plane.The length,width and thickness of the anterior interosseous talocalcaneal ligament were 13.90 ±1.55 mm,8.41 ± 1.11 mm,1.76 ± 0.35 mm.The length,width and thickness of the posterior ligament of the calcaneus were 9.89 ± 1.17 mm,9.05 ± 0.35,1.79 ±0.65 mm.The angle between the interosseous talocalcaneal ligament on the calcaneus and the coronal plane of the ankle joint was 36.00 ± 4.12 °.The angle between the trabecular portion of the anterior interosseous talocalcaneal ligament and the ankle joint is 35.42 ± 0.98 °.The angle between the rear interosseous talocalcaneal ligament and the ankle joint is 85.14 ± 3.98 °.The angle between the interosseous talocalcaneal ligament and the ankle joint is 72.57 ± 2.76 °?2.Cervical ligament and interosseous talocalcaneal ligament MRI examination route2.1 Cervical ligament MRI examination routeIn the midst of the median position of the ankle axial,coronal and sagittal scan.?To the ankle joint axial and coronal as a reference plane.Firstly,set the scan positioning line and cervical ligament in the axial direction of the MRI direction;Followed by an ankle coronal image from the outside obliquely on the inside of the MRI scan positioning line and ankle joint horizontal plane into a 46 °tilt;Finally,the neck ligament within the tilt sagittal scan.? Firstly set the scan positioning line and the neck ligament in the axial direction of the axial direction,and finally the neck ligament oblique plane scan.2.2 Interosseous talocalcaneal ligament MRI examination routeIn the midst of the median position of the ankle axial,coronal and sagittal scan.?To the ankle joint axial and coronal as a reference plane.Firstly,set the MRI scan positioning line on the ankle axial image to 36 ° with the ankle coronal plane;Followed by the ankle sagittal image on the MRI scan positioning line and the ankle joint coronal position of 18 ° forward angle,The last line of the forward tilt of the coronal scan.? With the ? scanned oblique coronal position as the reference plane,In the forward tilt coronal image set MRI scan positioning line extroversion 5°and the posterior bundle parallel to the direction of walking;In the forward tilt coronal image set MRI scan positioning line tilt 55 ° and the front beam parallel to the direction of walking.3.Scanning results of the cervical ligament and the interosseous talocalcaneal ligament on the MRI3.1 Cervical ligament:The thickness,length and width of the neck ligament were2.64 ± 0.63 mm,18.69 ± 1.09 mm,10.06 ± 1.82 mm.The length and thickness of the cervical ligament were measured on the coronal plane of the MRI,which were 9.07 ±1.21 mm,18.07 ± 0.96 mm,2.13 ± 0.51 mm.There was no significant difference in the value of the cervical ligament in the sagittal plane and the oblique coronal plane(P>0.05),The results of the cervical ligament measured in the sagittal and oblique plane of the MRI were not statistically significant(P> 0.05)?3.2 Interosseous talocalcaneal ligament:The thickness?length and width of the anterior tibia were measured on the anterior coronal plane of the MRI.The width and width were 1.79 ± 0.58 mm,14.56 ± 1.60 mm,7.34 ± 1.14 mm.The thickness,length and width of the posterior margin of the calcaneus were 2.00 ± 0.55 mm,9.64 ±1.11 mm and 8.76 ± 1.33 mm respectively.The width,length and thickness of the anterior tibial ligament were measured in the inclination sagittal position of MRI,respectively,5.07 ± 1.0mm,13.52 ± 1.09 mm,.1.34 ± 0.44 mm.The width,length and thickness of the posterior bundle of the Interosseous talocalcaneal ligament were 6.79± 0.89 mm,8.41 ± 0.89 mm,1.14 ± 0.28 mm respectively.There was no statistically significant difference between the anterior cartilage and the medial sagittal plane(P>0.05),There was no statistically significant difference between the anterior cruciate and the lateral sagittal plane(P> 0.05),The results of anatomical measurements on the anterior coronal and medial sagittal plane of the anterior tibial ligament of the calcaneus were not statistically significant(P> 0.05),There was no statistically significant difference between the calcaneal and the oblique sagittal surfaces of the anterior cruciate ligament and the anatomical measurements(P> 0.05).Conclusion:1.MRI scanning program of interosseous talocalcaneal ligament1.1 In the ankle axial position on the front oblique 36 °,The anterior oblique coronal plane of 18 ° forward on the coronal position shows the anterior and posterior bundles of the interosseous ligament.1.2 In the ankle axial position within the oblique 54 °,the anterior obliquecoronal position within the rear tilt of 55 ° within the tilt sagittal position from the interosseous talocalcaneal ligament of the front beam.1.3 In the ankle axial position within the oblique 54 °,the anterior oblique coronal position on the forward 5 °tilt sagittal position shows from the interosseous talocalcaneal ligament after the beam.2.MRI scans program of cervical ligaments2.1In the axial position before the oblique 61 °,the coronal position before the tilt 46 ° of the medial sagittal plane shows the cervical ligament.2.2 An oblique coronal plane with an oblique angle of 29 ° in front of the axis shows the neck ligament.