小儿长骨骨髓炎的MRI表现

MRI manifestations of long bone osteomyelitis in children

目的:探讨不同年龄组间小儿长骨骨髓炎的MRI表现。方法:在我院确诊为血源性骨髓炎并行MRI检查者38例;按年龄分成A组(年龄≤18个月)和B组(年龄>18个月)。分析比较两组患者的临床表现、部位、病灶在长骨中的部位(骨骺、干骺端或骨干)、病灶信号、骨膜下脓肿、关节积液等。采用SPSS 19.00软件进行统计学分析。结果:本研究中病变最常累及的部位:A组为股骨(52.3%),B组为胫骨(50.0%),两组间差异无统计学意义(P>0.05)。A组中累及干骺及骨骺者占81.0%,在B组中累及干骺端及骨骺者占50.0%,累及干骺端及骨干者占30.0%,两组间差异无统计学意义(P>0.05)。低年龄组中炎症累及骨骺的发生率与高年龄组间的差异有统计学意义(P<0.05)。A组中合并关节炎者占81.0%,B组中为45.0%,两组间差异有统计学意义(P<0.05)。结论:小儿长骨骨髓炎的主要MRI表现为病变多位于干骺端,常合并软组织炎症;小于18个月的幼儿骨髓炎易向骺侧扩散而并发关节炎,而大于18个月的儿童骨髓炎更易于向骨干延伸。

Objective：To study the MRI manifestations of long bone osteomyelitis of different age groups in pediatric patients. Methods：Thirty-eight patients who were diagnosed as hematogenous osteomyelitis underwent MR examination in our hospital were included in this retrospective study. They were divided into two groups according to age. Group A included children who were less than 18m of age whereas Group B were elder than 18m. The clinical materials, MRI features inclu- ding anatomic location （epiphysis, metaphysis or diaphysis）, signal intensities, sub-periosteal abscess, joint effusion were analyzed. SPSS were used for analysis. Results： The most common bone involvement in Group A was femur （52. 3%）, whereas in Group B was tibia （50.0%） ,with no significant statistical difference （P〉0.05）. Metaphysis and epiphysis in- volvement accounted for 81.0 % in Group A, while in Group B metaphysis and epiphysis involvement was 50.0 %, metaph- ysis and diaphysis involvement was 30% ,with no statistical difference （P〉0.05）. The incidences of epiphysis involvement in the two different groups were statistically significant （P〈0.05）. The incidences of joint involvement in Group A and Group B were 81.0% and 45.0%, respectively, with significant statistical difference （P〈0.05）. Conclusion： The MRI mani- festations of osteomyelitis of long bone included involvement of metaphysic, usually accompanied with soft tissue inflamma- tion. In patients less than 18m of age,infection inclined to spread to the epiphysis and complicated with arthritis, while in the group〉18m of age,infection inclined to spread to diaphysis.