CT与MRI对创伤性膝关节积脂血症的诊断价值

CT and MRI in the Diagnosis of Traumatic Lipohemarthrosis

目的探讨CT与MRI对创伤性膝关节积脂血症(traumaticlipohemarthrosis,TLH)的诊断价值。方法回顾性分析34例TLH的普通X线平片、CT及MRI的影像学表现,并探讨其诊断价值。结果 34例患者中,左膝关节22例,右侧膝关节12例。34例均行普通X线平片检查,提示膝关节骨折32例;16例行CT检查,15例可见明确脂肪、关节液、血液不同成分的分层密度改变。18例行MRI检查,均可见"脂肪-血液接口征"。并拟诊隐性骨折2例。结论 X线平片对骨折的诊断意义大,对积脂血症的诊断帮助不大。CT及MRI均能很好显示创伤性TLH,均有"脂肪-血液接口征"这一特征性表现,尤其MRI除显示积脂血症的典型征象外,对隐性骨折的诊断更有意义。

Objective To analyze the value of CT and MRI in diagnosing traumatic lipohemarthrosis （TLH）. Methods The CT and MRI data of 34 patients with TLH were analyzed retrospectively. Results Thirty-four patients of 22 left knees and 12 right knees were included in the study. All the patients performed X-ray examination, and fractures were found in 32 knees. 16 patients performed CT examination, fractures were found in 15 knees, and lipid-fluid-blood interfaces were showed in 15 lesions additionally. 18 patients underwent MRI examination, lipid-blood interfaces were showed in 18 cases and 2 cases of occult fracture were found on MR images. Conclusion X-ray is used to diagnose bone fracture, but not a good method for lipohemarthrosis diagnosis. CT and MRI can show lipid-blood interface, which is a specific feature of lipohemarthrosis. Furthermore, MRI is helpful for occult fracture diagnosis.