摘要
目的:分析MRI在青少年应力性骨折的诊断价值,以提高对本病的认识。方法:回顾性分析12例青少年应力性骨折病例的临床资料、X线和MRI表现,所有病例均无基础性疾病,并经治疗后随访复查证实。男9例,女3例,年龄6岁4个月至14岁3个月,平均12岁3个月。所有12例病例均先行X线摄片,2天内行MRI平扫检查。结果:(1)发生部位:结合X线和MRI检查,均在下肢不同部位发现应力性骨折,其中左胫骨近段6例,双侧胫骨近段、左侧胫腓骨近段、右胫骨近段、右胫骨中段、右股骨下段、左侧第三跖骨各1例。(2)X线表现:12例病例,4例X线阴性,8例X线可见各种异常表现,包括髓腔内横行致密线/带(6例)、骨膜反应(6例)、骨皮质增厚(1例)。(3)MRI表现:MRI清晰显示髓腔内骨折线,表现为T1W和T2W序列均为低信号,邻近髓腔内见骨髓水肿,骨膜均有不同程度增厚,周围软组织明显水肿。(4)随访:所有病例经石膏固定制动休息后1~3个月复查,疼痛症状均明显好转,X线片显示病变部位骨膜增厚,骨髓腔密度接近正常。1例左胫骨近段骨折病例于2年9个月后再次发生应力性骨折(双侧股骨远段)。结论:青少年应力性骨折正逐步得到认识,X线平片在诊断本病时的作用有限,MRI的诊断价值则举足轻重,且其具有无辐射的优点,从而成为本病诊断不可缺少的检查方法。
Purpose:To analyze the value of MRI in diagnosis of stress fracture in adolescents in order to improve the knowledge of this disease.Methods:The clinical data,X-ray and MRI findings of 12 cases of stress fracture were retrospectively analyzed.All 12 cases had no basic diseases and were confirmed by follow-up exam after treatment.There were 9 males and 3 females,aged from 6 years 4 months to 14 years and 3 months with an average age of 12 years and 3 months.All 12 cases were undergone X-ray first and MRI within 2 days.Results:(1)Locations:combined with X-ray and MRI examination,stress fractures were found in different parts of lower limbs,including 6 cases of left proximal tibia,1 case of bilateral proximal tibia,left proximal tibia and fibula,right proximal tibia,right middle tibia,right distal femur and left third metatarsal respectively.(2)X-ray findings:in 12 cases,4 cases were negative,8 cases were found with abnormal X-ray findings,including 6 cases of transverse dense line/zone in medullary cavity,6 cases of periosteal reaction and 1 case of bone cortical thickening.(3)MRI findings:MRI clearly showed the fracture line in the medullary cavity,which was low signal intensity in both T1 W and T2 W sequences,bone marrow edema in adjacent medullary cavity,varying degrees of thickening of periosteum,and obvious edema of surrounding soft tissues were also found.(4)Follow up:all cases were followed up 1-3 months after plaster immobilization.X-ray showed that the periosteum was thickened and the density of bone marrow cavity was nearly normal.One case of left proximal tibia fracture occurred bilateral distal femoral fractures again after 2 years and 9 months.Conclusions:The occurrence of stress fracture in adolescents has been gradually recognized.The role of Xray films in the diagnosis of the disease is limited.MRI plays an important role in the diagnosis of the disease.At the same time,MRI has no radiation,so it is indispensable for the diagnosis of the disease.
作者
周莺
孙燕
郭辰
徐琳
李玉婵
ZHOU Ying;SUN Yan;GUO Chen;XU Lin;LI Yuchan(Department of Radiology.Shanghai Children's Medical Centre,Shanghai Jiao Tong University School of Medicine;Department of Orthopaedics,Shanghai Children s Medical Centre,Shanghai Jiao Tong University School of Medicine)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2021年第4期341-346,共6页
Chinese Computed Medical Imaging
关键词
应力性骨折
青少年
数字X射线摄影
磁共振成像
Stress fracture
Adolescent
Digital radiography
Magnetic resonance imaging
