质子加权预饱和脂肪抑制在骨挫伤中的诊断价值

The value of MRI PDW-FS sequence in the diagnosis of bone contusion

目的:探讨质子加权预饱和脂肪抑制(PDW-FS)在骨挫伤中的诊断价值。方法:108例四肢关节外伤患者在伤后60天内行多序列高场强(1.5T)MR检查,检查序列包括快速SE T1WI、T2WI及PDW-FS等。受伤部位为膝关节87例,髋关节9例,肘关节3例,肩关节6例,踝关节3例。结果:108例四肢关节外伤患者MR检查发现骨挫伤征象97例181处,隐性骨折36例。骨挫伤MR信号主要表现为T1WI、T2WI呈片状、地图状不规则低或稍低信号影,PDW-FS呈更明显片状、地图状不规则高信号影,PDW-FS序列更易认识辨别。结论:MRI能发现急性及慢性骨挫伤的存在,骨挫伤常伴随其它严重损伤,如隐性骨折等,MR检查的PDW-FS序列是明确诊断的最佳序列,可以作为骨关节创伤MR检查的常规序列。

Objective：To investigate the value of MR imaging of proton density weighted-fat uppression （PDW-FS） sequence in detecting bone contusion.Methods： 108 trauma patients were studied using radiography and MR imaging within 60 days. MR sequences include： FSE T1WI, T2WI and PDW-FS.87 bone contusions occurred in the knee joint,9 in the hip joint,3 in the elbow joint,6 in the shoulder and 3 in the ankle. Results： 181 places of bone contusion（ in 97 cases） were found in all 108 patients. MR imaging demonstrated irregular low signal in the subcortical region on both T1WI and T2WI. The high signal in PDW-FS sequence was more remarkable and wider than that on both T1WI and T2WI. Conclusion： MR imaging could determine the diagnosis of acute and chronic bone contusion and correctly detect the complication such as occult fracture. The PDW-FS sequence would be the best effective among the T1WI,T2WI and PDW-FS, the PDW-FS should be used as a routine sequence for bone and joint trauma.