四肢关节专用MRI诊断剥脱性骨软骨炎的价值

目的探讨四肢关节专用MRI对剥脱性骨软骨炎（OCD）的诊断价值。方法回顾性分析52例经关节镜或手术病理证实为OCD患者的影像资料，评价剥脱性骨软骨炎的MRI特点。结果OCD MRI表现为关节承重部位软骨下骨质不同程度缺损，依据损害的范围和形状、部位、软骨和软骨下骨的情况，碎片下方的高信号区域和是否存在游离体，将OCD MRI表现分为Ⅴ型：Ⅰ型6例、Ⅱ型13例、Ⅲ型20例、Ⅳ型9例、Ⅴ型4例。结论OCD在MRI有特征性表现，是早期诊断的首选检查方法。四肢关节专用MRI可为临床鉴别诊断、判断OCD的稳定性，选择治疗手段提供依据。

Objective To discuss the diagnostic value of the dedicated extremity MRI for osteochondritis dissecans （ OCD ） . Methods Totally 52 cases with osteochondritis dissecans confirmed by arthroseopy and operation pathology were retrospectively arialyzed, and their MRI features were evaluated. Results MRI showed different degree defect of the subchondral bone in load-beating parts of articulation.According to the extent, shape and position of the damage, cartilage and the subchondral bone, high signal area under the debris and whether the presence of free body, 52 cases were classified into five types： 6 cases of type I , 13 type II, 20 type III, 9 type IV, 4 type V. Conclusion OCD has characteristic signs in MRI, so MRI is the first choice for early diagnosis. The dedicated extremity MRI can provide the evidence for clinical antidiastole, stability judgement, and treatment method.