磁共振成像在隐性骨折临床早期诊断中的应用价值分析

Analysis of application value of magnetic resonance imaging in the early diagnosis of occult fracture

目的探讨磁共振成像对隐性骨折患者临床早期诊断的应用价值。方法随机从急诊X线检查中选取未发现明显骨折而怀疑有隐性骨折的患者40例,分为MRI诊断组20例与X线复查组20例。X线复查组于就诊次日再次行X线检查,MRI诊断组次日行MRI检查,2组均在初诊2周后行受伤部位CT扫描检查最终确诊,比较2组患者诊断准确率,并观察不同受伤部位的MRI表现。结果 MRI诊断组诊断准确率(95.0%)显著高于X线复查组(15.0%),差异有统计学意义(P<0.05)。MRI表现冠状面T_1WI脂肪抑制序列与短T_1反转恢复(short TI inversion recovrey,STIR)显示较好,T_1WI、T_2WI呈条状或不规则状低信号带,T_2WI四周显高信号,T_2的压制序列明显,STIR显示水肿范围及骨折线表现良好。部分病例T_1WI、T_2WI均能看见明显的骨皮质与骨折线断裂征象,少数患者T_1WI的低信号带四周呈高信号,现小片状或斑点状,T_1WI呈高信号。结论 MRI可显著提高隐性骨折患者的临床早期诊断准确率,降低漏诊率,且可清楚显示不同隐性骨折的具体情况,有利于早期诊断与治疗,具有重要的临床应用价值。

Objective To explore the early diagnostic value of magnetic resonance imaging(MRI)in patients with occult fracture.Methods Forty cases were randomly selected,whose Xray examination were not find a clear fracture in emergency but with suspected occult fractures infact.All these patients were divided into two groups.On the next day,the X-ray group underwent X-ray examination once again,MRI examination were performed in MRI group.Two groups were performed CT scan to check the final diagnosis after two weeks,and then compare the two groups of patients with diagnostic accuracy to observe the MRI manifestations in different injured parts of body.Results The accurate rate of diagnosis of MRI group(95.0%)was significantly higher than the X-ray group(15.0%),The difference was statistically significant(P<0.05).MRI T_1 WI fat suppression sequence with short TI inversion recovery(Short TI inversion recovrey,STIR)showed better fracture line T_2 WI,T_1WI line like low signal around.STIR showed edema and fracture line of good performance.In part of patients,MRI showed T_1 WI,T_2WI strips or irregular low signal band around T_2 WI significantly high signal suppression sequence of T_2 was T_1 WI and T_2 WI.Some cases can see obvious cortical bone fracture line and fracture features,with low signal around a small number of patients with T_1 WI showed high signal,the small patches or spotted,T_1 WI showed high signal.Conclusion MRI can significantly improve the clinical diagnostic accuracy of occult fracture patients,and can clearly show the specific circumstances of different occult fractures,which is conducive to clinical early diagnosis and treatment,and has important clinical application value.