非潜水性下肢骨梗死的影像学诊断

Non diver bone infarction diagnostic imaging

目的探讨骨梗死的影像学表现特征,提高影像学诊断水平。方法回顾性分析经临床随访和病理证实的8例骨梗死患者的DR、CT及MRI影像学资料,将骨梗死分为急性期、亚急性期和慢性期,并与病理相对照。结果骨梗死急性期DR、CT扫描仅表现为局部的骨质疏松,MR T1WI呈等或稍低信号,T2WI呈等或稍高信号,STIR呈不均匀斑片高信号;亚急性期骨梗死DR及CT表现为虫噬样骨质破坏及斑点状硬化,MR T1WI中央呈等或稍低信号,T2WI中央为等或高信号,边缘呈典型的地图样改变;慢性期DR及CT表现为髄腔内不规则蜿蜒状硬化斑块,伴结节状低密度区。结论 MRI是诊断急性期骨梗死最有价值检查方法,能够发现早期病变,DR、CT对亚急性期和慢性期骨梗死病变有帮助,并可见特征性的影像表现。

Objective To explore the imaging features of bone infarction and improve imaging diagnostic accuracy. Methods The imaging data of 8 cases bone infarction with DR, CT and MRI were retrospectively analyzed, proved by clinical manifestation and surgical pathology. The lisions were classified into acute, subacute and chronic stages. The imaging findings were compared with pathological results. Results Partial osteoporsion could be seen on DR and CT in the acute phase, which as iso-low signal on MR TIWI and iso-high signal on MR T2WI, showed high signal on MR STIR. In the subacute stage, the bone infarction was characterize by punctate sclerosis and bone destruction like insect bite, iso-low signal on MR T1WI and high signal on MR T2WI were visibled, the margin of the lisions shown rugged and rough low signal band on MR STIR. In the chronic stage, DR and CT showed irregular,map-shaped sclerotic rim in the bone marrow. Conclusion MRI is the best wy to examine and detect the acute bone infarction, DR and CT1 has the imaging features in the chronic stage.