Imaging Research Of Ankle Injure Of Professional Football Players

Part ? A comparative study of the application of 3D isotropic MR imaging in ankle estimationObjective:This study aimed to identify the image quality of isotropic 3D-FSE?3D-FFE and 2D-FSE in the anatomical structure evaluation of the ankle.Methods and Materials:Participants:Ten healthy volunteer ankles were performed by 1.5T MRI machine without any symptoms.Imaging Technique:Ankles MR scanning were performed by Philips Achieva 1.5T MRI with ankle SENSE coil on supine position.The sequences included isotropic 3D-FSE?3D-FFE and 2D-FSE sequence.Conventional 2D-FSE sequences were also used for scanning the standard planar,including axial T2WI,coronal T1WI,sagittal T2WI;In addition,isotropic 3D-FSE and 3D-FFE were scanned with the non-standard sagittal planar,and the position lines are parallel to the long axis of the foot.Image evaluation and data measurement:Two radiologists measured the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the tissue and evaluated the image quality of all imaging under the three sequences of the ankle with 5-point Likert scale in double blind reveal.Statistical method:All the data were analyzed with SPSS 19.0 statistical package.Inter observer agreement was calculated by using the Kappa analysis.SNR and CNR of the tissue and quality analysis of ankle image were tested using LSD-t and Dunnett's T3.P?0.05 was considered as significant.Results:Compared to 3D-FFE and 2D-FSE,the SNR of 3D-FSEpresented the highest in all tissue,and as well as the highest CNRs were observed in cartilage-marrow,muscle-tendon,and tendon-fluid couples.For the estimation of the image quality of cartilage,3D-FFE displayed the highest score and the second was 3D-FSE.Meanwhile,3D-FSE presented the highest score among all sequences in the evaluation of image quality of tendon.Moreover,the statistical differences were observed among all sequences.Conclusion:3D-FSE sequence can be used to evaluate the cartilage,ligament,and tendon because of its better image quality.Furthermore,3D-FFE sequence can be used to evaluate the cartilage for the better image quality.However,2D-FSE sequence can be used to evaluate the ligament and tendon.Part ? The study of imaging manifestation of the ankle of the professionalfootball playersObjective:To observe the imaging characteristics of chronic ankle injure of professional football players and analyze the influence factors for leading to the chronic ankle injures of professional football players.Explore the diagnostic value for the ankle injuries of professional football players by the X-ray,CT and MRI,Materials and Methods:Subjects:Male professional football players(N=32,18-36 years old,mean age 21.24 ± 2.79)were performed X-ray,CT and MRI examination.However,28 of them were performed X and CT examination.In addition,30 of all players were only performed MRI examination.The football players with ankle fractures,tumor,infection and using non-steroidal anti-inflammatory drugs were excluded.Imaging techniques:Ankle joint images were taken from anterior-posterior and lateral on the standard position by using X-ray examinations(Philip VM DR).CT scan was performed by using Toshiba Aquilion(64-detector row 128-slice CT scanner).All examinations were performed on supine position,foot-first-entering for all football players.All the ankles of football players were measured by MRI(Philips Co.1.5T Achieva)at the supine position,foot-first-entering and used special coil of ankle.Conventional 2D-FSE sequences included axial T2WI,coronal T1WI,PDWI,sagittal T2WI were also presented.Isotropic 3D-FSE and 3D-FFE sequences were performed in non-standard sagittal planar,the position lines were parallel to the long axis of the foot.Statistical Methods:Data were processed with SPSS 19.0.Pearson ?2 test was used to analyze the incidence of chronic ankle injure,the significant level a= 0.05.Non-parametric Wilcoxon test was used to analyze the ranked data of severity of ankle joint disease.The correlation of the clinical data and chronic ankle injure was analyzed by the Binary Logistic regression.The statistical difference was considered when p?0.05.Result:1.On the X-ray plan,the Osteophytes,loose bodies and os trigonum were the major abnormalities for professional football players,and its incidence was 56.6%,17.0%,56.6%respectively.Osteophytes were showed beak-like spur,loose body was ovoid high density shadow and os trigonum was triangle or ovoid bone behind talus.2.On the CT examination,the Osteophytes,loose bodies,os trigonum,osteochrondal injure and bone cystic change were the major abnormalities for professional football players,and its incidence was 89.1%,40.0%,60.4%,5.5%,5.5%respectively.The abnormal changes of bone were showed more clearly and a higher the incidence was presented by CT scanning.Cartilage damage and the bone cystic under the articular surface were observed in CT scanning as well.3.On the MRI examination,the major abnormalities of professional football players focused on the bone,ligament and tendon.The abnormalities of bone included bone mallow edema and osteochrondal injure,and its incidence was 30.0%and 12.0%respectively.The ligament injure included anterior tibiofibular ligament,calcaneofibular ligament and deep layer of deltoid ligament injure,and its incidence was 36.0%,10.0%and 12.0%respectively.The tendon injure included posterior tibialis tendon,flexor hallucis longus tendon and flexor digitorum longus tendon injures,and its incidence was 90.0%,90.0%and 60.0%respectively.As the influencing factors of chronic ankle injure by Binary logistic regression analysis,the results showed that osteochrondal ligament and tendon injure were related with time length for engaged professional football players,height and weight of football players.The longer time length for engaged professional football players was longer,the higher height and the heavier weight increased the incidence of ankle damage.Conclusion:The major clinic image showed that chronic ankle injures of professional football players was mainly for bone,ligaments and tendons injures.The incidence of the osteophyte was the highest among abnormal bone changes,which may result in"soccer ankle".The incidence of anterior tibiofibular ligament injure was the highest among ligaments.The incidence of posterior tibialis tendon injures was the highest among tendons.The influencing factors of osteochrondal,ligament and tendon injure were related with exposure time of playing football,height and weight of football players.Part ? A comparative study of imaging demonstration of chronic ankle injure ofprofessional football players with normal subjectsObjective:We investigated and compared the incidence of chronic ankle injure of the normal subjects with professional football players,and analyzed the imaging characteristics of their chronic ankle injure.Materials and Methods:Professional football players group:There were 51 male players participated in X-ray examination,55 players in CT examination,and 50 players in MRI examination.Their ages among 18-36 years old,they were examined in the Third Affiliated Hospital of Southern Medical University from June 2014 to December 2014.Normal subjects group:There were 51 male players participated in X-ray examination,42 players in CT examination,and 50 players in MRI examination.Their ages among 18-36 years old,some of them visited the doctor because they had ankle sprain or minor injuries.Imaging techniques:as the same as the second part.Statistical Methods:Data were processed with SPSS19.0.Pearson ?2 test was used to analyze the rate of two or multiple independent samples,the significant level a= 0.05.Non-parametric Wilcoxon test was used to analyze the ranked data of severity of ankle joint disease.Results:1.The incidence of osteophytes,loose body formation and os trigonum were presented significant differences between professional and normal subjects in X-ray/CT(p<0.05),and the incidence of professional football players was 89.1%,40.0%,58.2%respectively,and the incidence of normal subjects was 45.2%,19.0%,7.1%.The incidence of professional football players was significantly higher than normal subjects.2.MRI examination showed the abnormalities in the two groups of ankle bone marrow edema,bursitis,joint effusion had significant difference(p<0.05),and the incidence of professional football players was 30.0%,80.0%,96.0%respectively,and the incidence of normal subjects was 12.0%,22.0%,70.0%respectively.The incidence of marrow edema,bursitis and joint effusion in professional football players was significantly higher than normal subjects.3.The incidence of two groups in the ligament injury had significant difference between anterior talofibular ligament,posterior talofibular ligament,calcaneofibular ligament(p<0.05).The incidence of professional football players was 36.0%,8.0%,10.0%respectively,and the incidence of normal subjects was 18.0%,0%,0%respectively.Morever,the incidence of the injury of anterior talofibular ligament,posterior talofibular ligament,calcaneofibular ligament of professional football players was significantly higher than normal subjects.4.The incidence of two groups in the tendons injury had significant difference with posterior tibialis tendon,flexor hallucis longus tendon and flexor digitorum longus tendon(p<0.05),and the incidence of professional football players was 90.0%,90.0%,60.0%respectively,and the incidence of normal subjects was 2.0%,6.0%,0%respectively.The incidence of the injury of posterior tibialis tendon,flexor hallucis longus tendon and flexor digitorum longus tendon in professional football players was significantly higher than normal subjects.Conclusion:The incidence of chronic ankle injure of professional football players were significantly higher than normal subjects,the mainly bone changes were osteophytes,loose body formation.The most common injury of the ligament was the lateral collateral ligament injury.The most common injury of the tendons were posterior tibialis tendon,flexor hallucis longus tendon and flexor digitorum longus tendon injury.