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目的:评估在牵引状态下应用MR小FOV表面线圈BLADE序列对踝关节距骨软骨损伤MR成像的应用价值。方法:前瞻性分析2018年12月至2020年7月南京医科大学附属苏州医院53例踝关节软骨损伤患者的临床及影像资料。所有患者均接受以下MR序列检查:序列Ⅰ为表面线圈小FOV的快速自旋回波质子密度加权的刀锋(FSE-PD-BLADE)序列成像;序列Ⅱ为踝关节水平方向负重牵引下小FOV的FSE-PD-BLADE成像。采用配对样本Wilcoxon秩和检验比较序列Ⅰ与序列Ⅱ的距骨穹顶软骨厚度、软骨间隙及图像质量(包括损伤处软骨上表面轮廓、损伤处软骨层厚、损伤处软骨有无断裂、损伤处软骨与软骨下骨的关系、软骨下骨质塌陷或骨小梁骨折线)的主观评分。结果:序列Ⅰ与序列Ⅱ距骨中心软骨厚度测量值差异具有统计学意义[分别为0.70(0.60,0.90)、0.80(0.70,0.90)mm,n Z=-2.900,n P=0.004],序列Ⅰ与序列Ⅱ距骨内侧、外侧软骨厚度值差异无统计学意义(n P>0.05);序列Ⅰ与序列Ⅱ距骨中心[0.10(0,0.15)、0.89(0.63,1.00)mm]、内侧[0.10(0,0.31)、1.20(0.70,1.25)mm]、外侧软骨间隙值[0.18(0.08,0.23)、0.90(0.76,0.94)mm]差异均具有统计学意义(n P<0.001)。对距骨软骨损伤特征显示主观评分中,仅在软骨下有无骨质塌陷或骨小梁骨折线的比较中序列Ⅱ与序列Ⅰ差异无统计学意义(n Z=-1.480,n P=0.139),其余各项在序列Ⅱ与序列Ⅰ比较中差异均具有统计学意义(n P0.05). There were significant differences between sequence Ⅰ and sequence Ⅱ in the center [0.10 (0, 0.15), 0.89(0.63, 1.00) mm], medial [0.10(0, 0.31), 1.20(0.70, 1.25) mm] and lateral cartilage space [0.18(0.08, 0.23), 0.90(0.76, 0.94)mm] (alln P<0.001). As for the subjective assessment score of talus cartilage injury, except for score in subchondral bone collapse or bone trabecular fracture line between sequence Ⅱ and sequence Ⅰ (n Z=-1.480, n P=0.139), significant differences were found in all other scores (n P<0.05).n Conclusion:MRI of the ankle under traction is safe and feasible. Under the condition of horizontal traction, small FOV surface coil combined with BLADE sequence can better display talus cartilage injury.