成人足舟骨坏死病的影像学诊断

Imaging Diagnosis of Adult Müller-Weiss Disease

目的:分析和总结成人足舟骨坏死病(MWD)的影像学表现。方法:回顾性分析12例MWD的影像学表现,12例中有7例行X线检查,5例行CT检查,5例行MRI检查,主要分析足舟骨及邻近骨、关节影像学改变。结果:7例患者X线表现为足舟骨外侧部分不同程度变窄及骨质密度增加,Maceira不同分期具有相应的影像学表现。5例CT图像除可见足舟骨变窄及骨质密度增加外,2例足舟骨关节面下可见囊变,1例足舟骨可见斜行透亮线,1例足舟骨压缩明显并“距楔关节”形成。5例MRI图像可见足舟骨压缩变扁,骨髓水肿,2例可见伴有软骨损伤及软骨下囊变。1例患者可见距骨的骨髓水肿。结论:MWD有一定的影像学特征,X线多表现为足舟骨外侧压缩变扁,骨质密度增高,部分可分裂成两块,负重侧位X线片可进行Maceria分期,CT图像较X线更容易显示足舟骨压缩性改变及邻近关节炎性改变,MRI可见骨髓水肿及早期关节炎的变化。

Objective:To analyze and summarize the imaging features of Müller-Weiss disease(MWD).Methods:The imaging manifestations of 12 cases of MWD were retrospectively analyzed.7 patients underwent X-ray examinations.5 patients underwent CT examinations and 5 patients underwent MRI examinations.The imaging changes of the navicular bone and adjacent bones and joints were mainly analyzed.Results:The X-ray findings of 7 patients showed varying degrees of narrowing of the lateral part of the navicular bone and increased bone density of the navicular bone.Different Maceira stages had corresponding imaging manifestations.In addition to the narrowing of the navicular bone and increased bone density in 5 cases,subchondral sclerosis erosions were seen in 2 cases.Oblique translucent line was seen in 1 case.1 case showed obvious compression of the scaphoid bone and talocuneiform neoarticulation was formed.MRI images of 5 cases showed compression and flattening of the navicular bone and bone marrow edema,and 2 cases showed cartilage damage and subchondral sclerosis erosions.One patient showed bone marrow edema of the talus.Conclusion:MWD has certain imaging features.X-rays mostly show compression and flattening of the lateral side of the scaphoid bone,increase bone density,and some can be split into two pieces.The weight-bearing lateral X-ray can be used for Maceria staging.Compared with X-ray,CT images can easily show compression changes of scaphoid bone and inflammatory changes of adjacent joints.MRI can show bone marrow edema and early arthritis changes.