摘要
目的:评价X线平片及MRI对儿童股骨头骨骺无菌坏死病(Perthes病)的诊断价值。方法:回顾性分析40例Perthes病患者资料,其中单发32例,双侧发病8例,所有病例最终经临床证实。X线摄片采用标准前后位及蛙式位;MRI检查采用横断面和冠状面TSE序列,T1WITR560ms,TE15～30ms;T2WITR1500ms,TE100ms;矢状面TSE序列T1WITR450ms,TE30ms,层厚5mm,层距0.5mm;STIR序列TR2100ms,TE150ms,层厚6mm,层距0.6mm,检查时要求患者取标准仰卧位。结果:X线平片示早期21例,其中7例初次摄片时阴性,5例初次摄片表现为髋关节间隙增宽,中期12例,晚期7例,MRI示病灶信号表现以混杂信号多见,有7个可见线样征,5个双线征,43个髋关节有关节积液,15个有骨髓水肿,27个股骨头软骨不光滑或增厚。结论:X线前后位及蛙氏位摄片可较好地显示骨性改变,尤其在中晚期,但早期易漏诊;MRI对Perthes病有很高的敏感性,能较准确、全面地反映股骨头骨骺坏死情况,是诊断该病尤其是早期诊断的重要工具。
Objective：To evaluate the value of the radiography and MRI through analysing retrospectively the plain radiographic and MRI appearances with 40 necrosis of femoral capital epiphysis （Perthes＇ disease）. Methods：48 hips in 40（unilateral 32and bilateral 8） patients with femoral epiphyseal necrosis were studied. There were 34 boys and 6 girls,the mean age was 8.2 years old, ranged from 4 to 15 years old. All cases were confirmed by clinical symptoms eventually. Radiographs were obtained from a standard anteroposterior and frog position lateral views; MRI examinations included transverse,coronal,（TSE T1WI TR 560ms,TE 15-30ms;TSE T2WI TR 1500ms,TE 100ms）,and sagittal planes （TSE T1WI TR 450ms,TE 30ms;thick slices were 5ram,the slice intergap were 0.5mm） ,STIR on coronal planes（TR 2100ms,TE 150,6mm thickness and 0.6mm slice intergap）. Results： Radiographs showed 21 early-stage patients （7 cases showed negetive and 5 cases only showed increscent hip joint space in first radiographs）, 12 metaphase patients, 7 late stage patients; on MRI, most of the necrosis places showed farraginous signals, line-liked （ 7）, double-line-liked （ 5）, hip ioint effusion （43）,marrow edema （ 15）, non smooth or thicked cartilage （27）. Conclusion： Radiographs （standard anteroposterior and frog position lateral views） can preferably show the bone＇s changes of the Perthes＇ disease,especially in meta late stage, but it probably miss diagnosis in early stage; MRI is sensitive to the Perthes＇ disease and can correctly and roundly show the appearances of this disease, MRI is the important tool of diagnosis,especially early diagnosis.
出处
《放射学实践》
2005年第8期717-720,共4页
Radiologic Practice
