摘要
目的探讨关节软骨损伤和松质骨水肿的MRI诊断方法及其临床意义。方法收集我院1998～2004年间行骨关节检查并确诊有关节软骨损伤和松质骨水肿的病例72例,MR扫描采用MAGNETOMVISONplus1.5T超导型磁共振成像系统。松质骨水肿的诊断均经2名影像科医师和1名副主任医师以上职称骨科医师共同读片确诊。关节软骨损伤均以关节镜检查结果为最终诊断依据。结果松质骨水肿的MRI表现:在T1WI上表现正常35例(41处);呈斑片状、地图样略低信号30例(39处)。在T2WI上表现不明显47例(54处),16例表现为明显不均匀略高信号。病变在STIR+FS序列上表现最为明显,呈明显斑片状、地图样异常高信号。关节软骨损伤的MRI表现:软骨变薄且凹凸不平9例(13处);关节软骨中断不连续5例(8处),3例(3处)仅表现为局部关节软骨表面不光滑,另有6例(10处)在MR上未见明显形态结构和信号异常。MRI显示关节软骨损伤以梯度回波序列(FLASH2D)质子密度加权像上显示最为清楚。结论MR是诊断关节软骨损伤和松质骨水肿最理想的影像学方法。
Objective To discuss the features of cancellous bone edema and cartilaginous injury on MRI and their clinical significance. Methods We retrospectively reviewed the MRI features of 72 patients with cancellous bone edema and cartilaginous injury. MAGNETOM VISON plus 1.5 T superconduct magnetic resonance imaging system （SIEMENS） was used for MR scan. The diagnoses of cancellous bone edema were confirmed together by 2 radiologists and 1 senior orthopedic surgeon. The diagnoses of cartilaginous injury were confirmed by the results of arthroscopy. Results The imaging results of cancellous bone edema were shown as normal in 35 cases （41 areas） and as piece-like or map-like hypointense in 30 cases （39 areas） on the Tl-weighted sequence. No lesion was shown in 47 cases （54 areas）, and slight inhomogeneous hyperintense in 16 cases on the T2-weighted sequence. All the cancellous bone edema were identified on short TR inversion recovery and fat saturation sequences （STIR ＋ FS） T2-weighted imaging, and displayed evident hyperintense. In MRI, the cartilaginous injuries displayed attenuation and unevenness of cartilage in 9 cases, discontinuity of cartilage in 5 cases and no abnormal structure or signal in 6 cases. The proton-density weighted imaging of the grade spin-echo fast low angle shot sequences （FSLASH） was the best in displaying the cartiaginous injury. Conclusion MR examinations are the perfect method for diagnosis of cancellous bone edema and cartilaginous injuries.
出处
《中华创伤骨科杂志》
CAS
CSCD
2005年第8期737-740,共4页
Chinese Journal of Orthopaedic Trauma
关键词
软骨损伤
松质骨水肿
磁共振成像
诊断
Cartilaginous injury
Cancellous bone edema
Magnetic resonance imaging （MRI）
Diagnosis
