不典型骨髓炎的X线、CT和MR影像比较分析

Comparison of radiography,CT and MR imaging in the detection of clinical atypical pyogenic osteomyelitis

目的:比较不典型骨髓炎X线、CT和MR影像显示差异。方法:对26例不典型骨髓炎X线、CT和MR征象与手术病理结果对照并由双盲法分析确认。结果:26例中急性骨髓炎8例,慢性骨髓炎12例,骨脓肿和硬化性骨髓炎各3例,术前诊断正确仅20例,3例误诊为恶性骨肿瘤,3例误诊为良性骨肿瘤或肿瘤样病变。结论:全面分析不典型骨髓炎的X线、CT和MR影像特点及临床表现,了解病变的病理特征及演变趋势,对本病的诊断和鉴别诊断有很大帮助。

Objective： To compare radiography, CT and MR in the detection of clinical atypical pyogenic osteomyelitis. Methods： Twenty-six cases of atypical pyogenic osteomyelitis were imaged with radiography, CT and MRI. The imaging signs were analysed and diagnosed by double blind method compared with the pathologic findings. Results： Of the 26 cases, there were 8 cases with acute osteomyelitis, 12 cases with chronic osteomyelitis and 3 cases with Brodie＇s abscess and chronic sclerosing osteomyelitis, respectively. Radiography, CT and MR made a correct diagnosis in 20 cases, 3 cases were misdiagnosed as malignant bone tumors, and other 3 cases as benign bone tumors and tumor like lesions. Conclusion： It is very helpful to diagnose and differentiate atypical pyogenic osteomyelitis by analyzing X-ray, CT and MR features, understanding pathologic features and development tendency of the lesion.