四肢关节隐性骨损伤的影像学评价

Occult bone injury near the joint of the extremity:assessment with MR imaging

目的 :探讨四肢关节隐性骨损伤的影像学表现并评价X线平片及MRI检查的价值。方法 :搜集 3 4例有外伤史且临床检查提示有四肢关节骨损伤的病例。所有患者外伤后 1天内行X线摄片检查。随后行MRI检查 ,2周内行MRI检查 5例 ,2周后行MRI检查 2 9例。采用矢状位T1WI (TR 45 0msTE 12ms)、矢状位T2 WI加FS (TR 3 0 0 0msTE 96ms)及冠状位ME 2D (TR 775msTE 2 7ms)等序列成像 ,层厚为 4mm ,层间距为 0 .1mm。结果 :所有 3 4例患者 ,常规X线检查结果均为阴性。MRI检查 3 4例患者共发现 44个骨挫伤病灶 ,其中T1WI上 3 1个病灶 ( 70 .5 % )为较低信号 ,T2 WI加FS上 44个病灶 ( 10 0 % )全部表现为高信号 ,ME序列上 44个病灶 ( 10 0 % )全部表现为稍高或高信号。结论 :在隐性骨损伤的诊断中 ,MRI是目前最佳的检查方法。对于外伤后X线平片表现为阴性 ,而临床上仍疑诊为骨损伤者 ,有必要进行MRI检查 ,以T2 WI加FS和ME序列对隐性骨损伤的诊断最具价值。

Objective:To study the MRI features of occult bone and joint injury. Methods:The images of X-ray and magnetic resonance in 34 patients with bone injuries were reviewed.X-ray films of 34 cases were obtained within 24h.Magnetic resonance images of 5 cases were obtained in 2 weeks,and 29 cases were obtained over 2 weeks after injury.MRI was performed with T 1WI,T 2WI+FS,ME-2D sequences.Results:No evidence of abnormal density and fracture was revealed on the X-ray films.44 foci of the bone contusion were shown on the magnetic resonance images in 34 patients.On T 1W images,31 foci shown slightly low signal intensity.On T 2W + FS images,44 foci appeared hyperintense.On ME-2D images,44 foci showed slightly high or high signal intensity. Conclusion:The occult bone injuries can be easily found on magnetic resonance images.In patients suspected of bone injury but X-ray is negative, MR is necessary:T 2 weight + FS and ME-2D images were most sensitive for deductings the occult bone injuries.