儿童肘部创伤性病变DR的影像学表现及诊断价值

DR Imaging Fingins and Diagnostic Value of the Elbow Traumatic lesion in Children

目的:探讨儿童肘部创伤性病变DR的影像学表现及诊断价值。方法:回顾性分析40例儿童肘部创伤病变DR的影像学表现。结果:在40例儿童肘部创伤性病变中:21例肱骨髁上骨折(52.5%),7例肱骨外髁骨折(17.5%),6例肱骨内上髁骨折(15%),4例尺骨上端骨折伴桡骨近端向外移位,1例肱骨内髁骨折,1例肱骨远端全骨骺分离。结论:肱骨髁上骨折是儿童最常见的肘部骨折。肱骨前线是发现这类骨折的最好方法。脂肪垫征阳性与骨折及骨骺分离、骨质损伤高度相关。桡骨肱骨小头线用于判断桡骨头骨折、肘脱位,以及外髁移位性骨折。肱骨远端泪滴影的改变可有助于诊断儿童肱骨隐匿型或无移位性髁上骨折。目前DR检查仍是儿童肘关节损伤最重要的影像诊断方法之一。MSCT和MRI对诊断隐匿性骨折,骨骺、骺板及软组织损伤比DR具有更高的敏感性和准确性,是对DR成像不足的重要补充。

Objective：To explorer the imaging fingings and diagnosis of the common elbow traumatic lesion in children.Methods：The imaging fingings of the elbow fractures in 40 children were analized retrospectively.Results：40 cases of the elbow fractures include：21 cases with the supracondylar fractures（ 52.5%）,7 with lateral condylar fractures（ 17.5%）,6 with medial epicondylar fractures（ 15%）,4 the ulna is fractured just distal the coronoid process,and there is lateral dislocation of the radial head.1 the medial condylar fractures,1 separation of entire distal humeral epiphysis.Conclusion：The supracondylar fracture is the most common elbow fracture in children.Assessment of the anterior humeral line is the best way to detect a subtle supracondylar fracture.Children,s elbow fat-pad sign for the positive and frectures and seperation bone damage height related alone.The radiocapitellar line is used to judge dislocation of the radial head,elbow dislocations and displaced fractures of the lateralcondyle.The change of teardrop may helpful in diagnosis of the occult supracondylar fracture of the humerus in children.At present,DR inspection still is one of the most important diagnostic method of pediatric elbow injury.MSCT and MRI have higher sensitivity and accurcy than DR in diagnosing,elbow epiphyseal and epiphyseal plate injury,and soft tissue,and diagnose elbow occult fracture and complicated it is important supplementary for DR defects.