儿童长骨生长板损伤组织学和影像诊断  

Radiographic,Sectional Microangiographic and MRI Diagnosis of Long Bone Growth Plate Injury in Children

作　　者：王云钊[1] 刘薇[1] 李文峰[1] 程克斌[1] 

机构地区：[1]北京积水潭医院放射科,北京100035

出　　处：《放射学实践》2005年第8期736-738,共3页Radiologic Practice

摘　　要：目的:认识儿童生长板损伤不同类型的预后及易发生畸形的类型。方法:30例1～9岁儿童肘关节肱骨远端骺软骨骨折X线资料,3例肱骨远端生长板损伤MR成像,4例膝和踝关节生长板骨折MR成像,另有11只实验兔骨骺牵拉延长术后平片、微血管摄影和病理切片。生长板损伤采用SalterHarris分类法分为5型。结果:第3型,骨折线垂直经过骨骺然后水平向生长板裂开;第4型,骨折经过骨骺穿过生长板至干骺端骨折;第5型,损伤生长板的间叶细胞。上述三种类型都可发生骨骺早闭。而第1型(骨骺牵拉分离)和第2型(骨折线经生长板进入干骺端)一般预后好,不发生畸形。结论:儿童肘关节创伤X线平片和MRI可显示骨折解剖,准确的分型和判断预后是非常重要的。Objective：To observe the prognosis of various types of long bone growth plate injury in children to find out which type of injury can result in defermity. Methods.- Thirty children aged 1-9 years with fracture involving distal epiphyseal cartilage of humerus were shown on radiographs of elbow. Three cases of growth plate injury were shown on MRI of elbow joint. Four cases with fracture of the growth plate were shown on CT and MRI of knee and ankle. Post-operative radiographs,microangiography and pathologic sections of experimental traction of tibial epiphysis in rabbits for lengthening of the extremities. Results：Premature closure of the growth plate occurred in the following conditions：①Salter-Harris type 3：The fracture line passed through the epiphysis vertically and then horizontally toward the growth plate; ② Type 4： The fracture passed through the growth plate resulting in fracture of the metaphysis;③Type 5：Injury of the growth plate involving the mesenchymal cells. Premature closure of the growth plate occurred in all these 3 types of injury and no deformity occurred in type 1 and type 2. Conelution：Radiographs and MRI can demonstrate the anatomy of the fracture and its precise typing which is quite inportant in the prognosis.

关 键 词：关节损伤 软骨 磁共振成像 长骨生长板 

分 类 号：R726.8[医药卫生—儿科]