膝关节隐匿性骨折的影像诊断分析

发布时间：2018-03-01 05:34

本文关键词： 骨折闭合性膝关节磁共振成像　出处：《实用医学影像杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨多层螺旋CT(MSCT)三维重建及磁共振成像(MRI)在膝关节隐匿性骨折的诊断价值。方法连续选取30例CT三维重建或MRI诊断骨折而数字化X线摄影(DR)阴性的外伤患者的影像进行回顾性分析。30例行DR和MSCT三维重建检查,其中26例行MRI检查。结果 CT及MRI共显示隐匿性骨折43处,30例患者中MSCT漏诊7例,23例MSCT结合三维重建共显示骨折26处,26例MRI共显示骨折39处,MSCT漏诊7例为未累及骨皮质的骨内骨折,MRI表现为松质骨内T1WI线样低信号及T2WI低信号伴骨髓水肿。6例骨皮质隐匿性骨折MSCT检出骨皮质中断,MRI则未能明确显示骨折线,仅表现为骨折处皮质下T2WI模糊水肿高信号。结论 MRI显示膝关节隐匿性骨折及伴发骨髓水肿方面较CT更为敏感,尤其是骨内骨折;MSCT应用三维重建显示骨皮质骨折优于MRI,二者相互结合可减少膝关节隐匿性骨折的误、漏诊率。
[Abstract]:Objective to evaluate the diagnostic value of MSCT 3D reconstruction and Mr imaging (MRI) in occult fracture of knee joint. Methods Thirty consecutive cases of traumatic fracture diagnosed by CT 3D reconstruction or MRI but negative by digital radiography (DRR) were selected. 30 cases of Dr and MSCT 3D reconstruction were performed retrospectively. Results CT and MRI showed occult fracture in 43 sites in 30 cases. MSCT missed diagnosis in 7 cases and 23 cases in MSCT combined with 3D reconstruction. 26 cases of MRI showed 39 sites of fracture. 7 cases were not involved. MRI findings of intraosseous fracture of the cortical bone showed linear hypointensity in cancellous bone on T1WI and hypointensity on T2WI with bone marrow edema in 6 cases of occult fracture of bone cortex detected by MSCT. Conclusion MRI is more sensitive than CT in showing occult fracture of knee joint and bone marrow edema. In particular, MSCT of intra osseous fracture showed that the cortical fracture was superior to MRI.The combination of them could reduce the misdiagnosis and missed diagnosis rate of occult fracture of knee joint.
【作者单位】：江苏省连云港市第二人民医院放射科;
【分类号】：R683;R445.2

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