MRI不同序列在骨挫伤诊断中的应用价值

Application of different sequences in diagnosis of bone contusion

[目的]探讨MRI不同序列在骨挫伤诊断中的应用价值。[方法]对2006年8月～2006年12月间的45例骨挫伤患者行MRI检查，MRI扫描前均经CR、DR或CT扫描证实没有发生骨皮质的断裂与移位。临床主要表现为局部肿胀、疼痛及活动受限。使用SiemensNovus1．5T超导MRI机器，脊柱扫描使用肢体线圈，膝关节扫描使用膝关节线圈，行矢状位、冠状位及横断扫描。扫描序列包括自旋回波序列（SE）T1WI、快速自旋回波序列（TSE）T2WI、梯度回波序列（FL2D）T2WI、脂肪抑制序列T2WI。[结果]自旋回波序列（sE）T1WI检出44例，检出率为97．7％，快速自旋回波序列（TSE）T2WI检出37例，检出率82．2％，梯度回波序列（FL2D）T2WI检出24例，检出率75％，脂肪抑制序列T2WI检出45例，检出率100％。骨挫伤检出率脂肪抑制序列T2WI高于TSET2WI（P〈0．05），TSET2WI高于FL2DT2WI（P〈0．05）。骨挫伤高场MRI信号改变主要表现为T1WI呈低信号，rISET2WI呈等高信号，FL2DT2WI呈混杂稍高信号，脂肪抑制序列T2WI呈明显高信号。边界不清，信号不均匀。[结论]对于骨挫伤脂肪抑制序列T2WI检查好于TSET2WI及FL2DT2WI，与SE T1WI相结合能够更敏感的发现骨挫伤改变。

[ Objective]To investigate the clinical value of different magnetic resonance （MR） pulse sequences in the diagnosis of bone contusion. [ Method] Forty-five patients with bone contusion underwent magnetic resonance imaging （MRI）. All cases underwent computed radiography （CR） , digital radiography （DR）or computed tomography （CT）and no bone fracture were revealed. Complications included swelling,pain and limit activity. The sagittal, coronal and transversal scanning were performed by Siemens Novusl. 5T magnetic resonance imaging. The body coil were used on spines and knee coil on knees. MR pulse sequences included spin echo T1 WI, Turbo spin echo T2 WI, fl - 2d T2 WI and fat suppressed sequence T2 WI. [ Result ] In 45 cases with bone contusion, 44 cases were revealed on spin echo T1WI（97.7% ） , 37 cases on Turbo spin echo T2WI（82.2% ） , 24 cases on f1-2d T2WI（75% ）, 45 cases on fat suppressed sequence T2WI （100%）. The fat suppressed sequence T2WI was superior to TSE T2 WI （ 〈 0.05 ）and TSE T2 WI to FL2D T2 WI （P 〈 0.05 ）in bone contusion. The poorly-defined lesions showed hy- pointensity on SE -T1 WI, isointensity or hyperintensity on rISE -T2 WI, inhomogeneous intensity on fl -2d T2WI, and the remarkable hyperintensity on fat suppressed sequence T2WI. The poorly-defined lesions showed inbomogeneous intensity. [ Conclusion]The fat suppressed sequence is superior to rISE T2WI and FL2D T2WI in bone contusion. The bone contusion can be revealed effectively combination the fat suppressed sequence with SE T1 WI.