Multi-slice CT and MRI findings of the Lisfranc's ligament injuries

Abstract

Objective To explore the multislice CT and MRI features of the Lisfranc's ligament injuries.Methods In 23 cases of the tarsometatarsal joins injuries,16 are men and 7 are women.The average age is 37 years(range 17-67 years).Ten cases are induced by the direct force and 13 cases are caused by the indirect force.All of the 23 cases were examined by the Siemens 64-slice CT scan ,and then reformatted the tarsometatarsal joins with the MPR,CPR,SSD and VR.Ten of 23 cases were examined by oblique axial,sagittal and coronal view of the Siemens 1.5 T MRI.Results On CT ,the distance between the second metatarsus base and the medial cuneiform showed increase in 14 cases and the distance between the base of the second metatarsus and the first metatarsus was over 2 mm.In addition,the inside base of the second metatarsus and the lateral edge of the first cuneiform bone revealed fractures in 5 cases,respectively.The above CT characteristics may suggest the injuries of Lisfranc's ligament. Ten of the 14 cases were examined by MRI.The Lisfranc ligament was found to have injuries in these cases.The injuries were divided into 3 types:type Ⅰ (Lisfranc ligament breaks) was 5 cases;type Ⅱ (Lisfranc ligament shape is complete,but accompanied with avulsion fracture of the second metatarsal bone basis interior margin of attachment point of Lisfranc ligament) was 4 cases;and type Ⅲ (Lisfranc ligament shape is complete,but accompanied with avulsion fracture of exterior margin of the inside cuneiform of attachment point of Lisfranc ligament) was 1 case.Conclusion CT can demonstrate local soft tissue swelling,suggesting the Lisfranc ligament damage,and demonstrate clearly avulsion fracture of attachment point of Lisfranc ligament,but MRI can appraise accurately the Lisfranc ligament injuries. Key words: Ligament; joint; Tarsal joint; Dislocation; Tomography; X-ray computed; Magnetic resonance imaging