低场磁共振对膝关节隐匿性骨折诊断的评价

Evaluate of Low-field MRI in diagnosis of knee joint occult fracture

目的评价低场强MRI对膝关节隐匿性骨折的诊断价值。方法选择60例膝关节外伤后1小时-10天内X线检查阴性但临床高度怀疑膝关节隐匿性骨折的患者进行低场强MRI检查。结果60例膝关节隐匿性骨折中,股骨内外侧髁27例,胫骨平台19例,髌骨2例,腓骨小头3例,膝关节面相邻两端对吻骨折9例,表现为片状伴或不伴线样T_2WI高信号,T_1WI低信号,SPIR为高信号,多伴有韧带或半月板及软组织损伤。结论MRI对于膝关节隐匿性骨折的诊断具有很高的价值及临床意义,能提高早期诊断率,对临床治疗方法选择及减少误诊及漏诊都具有重要的意义。

Objective To evaluate the value of low-field MR imaging in diagnosing occult fracture Of knee joint. Methods Sixty patients who experienced acute knee traumas with obvious clinical symptoms and negative radiographic findings were perfomed MR examinations lh to 10 d after injury. Results Sixty occult fractures were detected in the lateral and medial femoral condyle in 27 cases, inferior to the tibial platform in 19 cases, 3 cases in the fibular head and 2 cases in the patella, ipsilaterul injuries on the femoral condyle and the tibial plateau （kissing contusion ） in 7 cases. Fractures were showed decreased signal intensity on T^WI, increased signal intensity on T2WI, marked by increased signal intensity on SPIR with ligament or meniscal and soft tissue injuries, which companied patchy lesions with or without linear abnormal signal intensity. Con- clusion Low-field MRI is a effective diagnostic method of occult fracture of knee joint , which can improve early diagnosis rate, it is important to clinic treatment and avoid the misdiagnosis and missed diagnosis of occult fractures in knee joint to a great extent.