摘要
目的:分析创伤性关节脂血症的影像学特征,探讨其对关节囊内骨折的诊断价值。方法:回顾性分析研究100例经手术或穿刺证实的创伤性关节脂血症患者行X线、CT及MRI检查并分析影像学资料。结果:100例患者经3种检查方法印证均存在关节内骨折。X线表现为关节囊肿胀,密度增高与肌肉近似,经特殊体位投照部分可显示脂液平征象。CT全部清晰显示关节囊内有脂液平征,其中单液-液平征72例,双液-液平征25例,气体脂肪血液单或双液-液平征3例。MRI有明确脂液平征89例,位于膝、髋等大关节。脂液平征不明确者11例,位于踝、腕等小而复杂的关节。构成关节囊内单液-液平征的上下2层液体和双液-液平征的上、中、下3层液体有明显不同的CT值和MRI信号强度,其中最上层CT为脂肪密度、MRI为脂肪信号。结论:CT示脂血症清晰而准确,对大部分囊内骨折能明确诊断。MRI对小关节脂血症的诊断不如CT,但对关节囊内骨折及其附属结构损伤的显示明显优于X线片及CT。创伤性关节脂血症可作为关节内骨折可靠的间接征象。
Objective：To investigate the manifestations of X-ray,CT and MR of the traumatic lipohemarthrosis and their diagnostic value. Methods： The X-ray,CT and MR characteristics of 100 cases with traumatic lipohemarthrosis proved by operation or puncturation were studied retrospectively. Results：Intra-articular fractures were shown on X ray,CT or MR in all 100 cases with traumatic lipohemarthrosis. X ray examination showed articular capsule swelling and increase of density similar to muscle,radiography in horizontal projection could display fat-liquid level;CT findings： fat-fluid level was found in all cases.single fluid-fluid level was found in 72 cases,double fluid-fluid level was found in 25 cases,gas fat-blood single or double fluid-fluid level was found in 3 cases; MRI findings： fat-fluid level was seen in 89 cases, located in knee and hip joints, fat-fluid level could not identified in 11 cases,located in ankle and wrist joints. CT attenuations and MR signal intensity of different layers was different,the uppermost layer showed fat density on CT and fat signal on MRI. Conclusion：X-ray is insensitive to lipohemarthrosis and limited in finding latent fracture. CT can clearly detect lipohemarthrosis and diagnose the most cases of intra-capsule fractures. MRI is inferior in diagnosing the small lipohemarthrosis to CT,but it is superior in showing the intra-articular fracture and injury of related structure. Traumatic lipohemarthrosis has typical CT and MRI appearance,and it always coexists with intra articular fractures, being a clinically useful sign in detecting intra-articular frac ture.
出处
《放射学实践》
北大核心
2010年第2期193-197,共5页
Radiologic Practice
关键词
创伤和损伤
关节囊
体层摄影术
X线计算机
磁共振成像
Wounds and injuries
Jointcapsule
Tomography,X-ray computed
Magnetic resonance imaging
