腕关节的磁共振成像技术与临床应用探讨

MRI scanning technology for wrist joint and its clinical application.

目的探讨腕关节的磁共振成像技术与临床应用价值。方法35例病例(男20例,女15例),应用矩形表面小线圈(CP Flex small coil)作患侧关节的快速双回波自旋序列(Pd+T2_tse)扫描、T1加权序列扫描(T1_se)、快速小角度单次激发成像(Fast low angle shot,FLASH)加脂肪抑制(fat suppress)(T2_fl2d+fs)序列扫描、多回波(Multiple echo 2 dimension,Me_2d)序列扫描。扫描范围包括腕关节的冠状位、轴位。结果优片率达到90%以上。35例中,三角纤维软骨板复合体(TFCC)损伤18例,关节炎症改变4例,腕关节骨折或骨挫伤8例,肌腱和韧带损伤10例,舟状骨坏死3例,关节积液3例,良性病变和占位各1例,腕关节退行性变3例,未见异常2例。结论腕关节的磁共振检查,Pd+T2_tse、T2_fl2d+fs、Me_2d作为冠状位的常规序列,辅以横断位的T1_tse序列扫描,即可满足腕关节损伤和病变的诊断要求。

Objective To discuss the clinical value of magnetic resonance imaging （MRI） scanning tech- nology in wrist joint. Methods 35 cases of wrist joint trauma were examined with MlqI using CP Flex small coil. It was performed through coronal pd ＋ t2_tse, T1WI, t2_fl2d ＋ fs, me_2d ; axial T1WI. FOV was big enough for the whole trauma wrist joint. The injured wrist joint was not allowed to move. Results The high quality rate was up to 90% for the wrist joint. Among 35 cases, 18 had traumatic lesion of triangular fibro eartilage（TFCC） , 3 had the change of osteoarthritis, 8 had wrist fractures or bone contusion, 10 had tendon and ligament damage, 3 had seaph-old necrosis, 3 had joint effusion, plus one in benign lesion space occupying lesion, 3 had degeneration of wrist, and 2 had normal images. Conclusion In MR examination of the wrist, the coronal Pd ＋ T2tse,T2_fl2d ＋ fs and Me_2d are the routine sequences,in the transverse scanning, the Tl_tse is the routine sequence, which can be satisfaetory in clinical diagnosis.