摘要
目的探讨骨梗死不同时期的影像学特点及其鉴别诊断,以提高对骨梗死的诊断水平。方法对15例骨梗死患者行X线、CT及MRI检查,将骨梗死分为早、中、晚三期,总结其影像学特征。结果 15例患者病变累及双侧者6例,单侧者9例;病变共累及23个部位。早期4例,X线未见明显异常或仅骨小梁模糊,MRI表现为病变区中央T_1WI呈等或稍低信号,T_2WI呈等或稍高信号,病变区边缘为蜿蜒迂曲的T_1WI低信号、T_2WI高信号带。中期7例,X线、CT表现为阴性和局部的斑片状钙化,MRI表现为病变中央T_1WI呈等或稍低信号,T_2WI呈等或稍高信号,病灶边缘清楚呈典型的地图样改变,在压脂T_2WI序列上可见明显的"双线征"。晚期4例,X线及CT表现为不规则、蜿蜒状骨质硬化,MRI T_1WI及T_2WI上均呈低信号。结论骨梗死各期有不同的影像学表现,MRI发现早、中期病变较X线和CT敏感,晚期X线、CT和MRI均具有特征性表现。MRI是骨梗死最好的检查手段。
Objective To explore the different period appearances characteristic and the differential diagnosis of the bone infarction,so as to improve accuracy of the bone infarction.Methods The 15 patients were undertaken the X-ray,CT and MRI examinations who diagnosed as the bone infarction by pathology and the follow-up examinations.The bone infarctions were divided into the early,mid-term,and terminal periods by their different imaging appearances.The characteristics were analyzed and concluded.Results In 15 patients,23 sites were involved,in which 6 patients were bilateral and 9 patients were unilateral.In early stage of 4 patients,there were no positive signs in X-ray or only the appearance of the bone trabecular vague,but in MRI,the infarction lesion appeared obvious abnormal signals such as same or high signals in T1WI and T2WI centrally,wriggle band of low signal in T1WI and high signal in T2WI peripherally.In 7 mid-stage patients,there were showed negative or not obvious patchy calcification in CT and X-ray films,and in MRI,there were seen centrally the same or little low signal in T1WI and same or little high signal in T2WI,and peripherally the clear irregular margin which were typically ＆quot;map-like＆quot; and obvious ＆quot;two-line signs＆quot; in fat-suppression T2WI.In 4 terminal stage patients,bone infarction lesions showed typical irregular and wriggle＂plait sign＂ in X-ray and CT films and low-signal appearances in both T1WI and T2WI.Conclusions The different periods of bone infarction show different imaging appearances.MRI is sensitive than X-ray and CT for early stage,in our study,the mid-term X-ray and CT appearances are not obvious,and in terminal stage there are some typical signs in all X-ray,CT and MRI.So MRI is the best way to diagnose early bone infarction.
出处
《临床骨科杂志》
2017年第3期325-328,共4页
Journal of Clinical Orthopaedics
