MR在诊断膝关节周围骨隐匿性损伤中的价值

An evaluation of MRI in the diagnosis of occult peri-articular bone injury of knee joint

目的评价膝关节周围骨质隐匿性损伤MRI诊断价值。方法31例外伤患者共33个膝关节均行X线平片检查及MR快速自旋回波(FSE)T1WI、FSET2WI、快速梯度回波(FFE)T2WI、频率选择及反转脉冲抑脂序列(SPIR)T2WI、SPIRPDWI以及三维水激励快速梯度回波T1WI软骨成像(3D/WATSc/FFE/T1WI)序列扫描。结果31例患者中33个膝关节周围骨均发现异常,其中骨挫伤20例,隐匿性骨折8例,关节软骨或骨软骨骨折5例。T2W/SPIR对骨挫伤显示清楚,呈大片状高信号;PDW/SPIR能清晰显示隐匿性骨折线,呈锐利的细线状、条带状高信号;3D/WATSc/FFE/T1WI显示软骨骨折最佳。结论MRI能准确显示并诊断外伤后膝关节周围骨隐匿性病灶,不同的扫描序列对不同类型的隐匿性病灶显示各有优势,应结合使用。

Objective An evaluation of MRI in the diagnosis of occult peri- ar ticular bone injury. Methods Thirty-one patients, in total thirty-three joints , underwent radiography and MRI. MRI sequences included FSE T1WI, FSE T2WI, T2WI /SPIR, PDWI/SPIR and 3D/WATSc/FFE/T1WI. Results Abnormities were found in thirty -three knee joints. Bone bruises were found in 20 knees, occult fractures in 8 and articular cartilage or osteochondral fractures in 5. T2WI/SPIR was successfu l in demonstrating the bone bruise. PDWI/SPIR provided good images of the occult fracture, while 3D/WATSc/FFE/T1WI was the best sequence to demonstrate the cart ilage fracture. Conclusion MRI provides vivid images of the peri-articular occu lt injury of knee. Various MRI sequences have respective advantages in different iating the nature of occult lesions and should be combined in clinical application.