膝关节急性隐匿性骨创伤的MRI分度标准  

Acute Obscure Bone Trauma of Knee Joint:the Standard of MRI Classification

作　　者：王玮[1] 崔光彬[1] 秦越[1] 丁勇[2] 李强[1] 熊小双[1] 李玮[1] 

机构地区：[1]第四军医大学唐都医院放射科,陕西西安710038 [2]第四军医大学唐都医院骨科,陕西西安710038

出　　处：《实用放射学杂志》2006年第5期559-562,共4页Journal of Practical Radiology

摘　　要：目的探讨膝关节急性隐匿性骨创伤的MRI表现和分度标准。方法收集我院2003-2006年问739例患者膝关节MRI病例。其中53例符合隐匿性骨创伤标准。年龄16-51岁，男32例，女21例。23例患者有关节镜检查结果。对照关节镜，综合MRI表现对膝关节急性隐匿性骨创伤MRI表现进行分级。结果①MRI检查发现，单纯骨髓挫伤6例，软骨损伤47例，其中1级损伤11例，2级13例，3级14例，4级9例。软骨下骨皮质微骨折的6例；②23例患者关节镜检查，按国际软骨修复学会（ICRS）标准，发现0级2例，1级2例，3级6例，4级5例，有4例患者镜下见到软骨下骨皮质微骨折；③MRI与关节镜分级结果比较，16例两者分级结果一致。7例有差异，其中5例MRI评级比关节镜低一级，2例MRI评级比关节镜高一级。结论MRI是诊断膝关节急性隐匿性骨创伤的首选无创检查方法。Objective To study MRI appearances and the standard of classification of acute obscure trauma of knee joint. Methods MRI of 739 patients with knee joint trauma in our hospital. 53 of them （male 32, female 21） suffered with obscure trauma of knee joint. Aged from 16 to 51 years old. 23 cases were examed by arthroseopy, the MRI scale of acute obscure trauma of knee joint was determined by the result of arthroscopy and the appearance of MRI. Results ①MRI of 53 cases showed：bone contusions in 6 cases, chondric injury in 47 cases（6 cases of minute subchondral bone fracture）. In the cases of chondric injury,there were Ⅰ° in 11, Ⅱ°in 13, Ⅲ°in 14 and Ⅳ°in 9; ② 23 patients were examed by arthroscopy . According to the standard of the International Cartilage Repair Society （ICRS） , it was found that 2 cases were in 0 stage, 2 cases in 1 stage ,6 cases in 3 stage and 5 cases in 4 stage. It was also found that 4 of them were minute subchondral bone fracture;③By comparing the result of MRI with that of the arthroscopy , it was found that the result was the same both of MRI and arthroscopy in 16 cases. While 7 cases were different,of 7 cases,5 cases tested by MRI were one degree lower than that of arthroscopy, and 2 cases tested by MRI were one degree higher than that of arthroscopy. Conclusion MRI is the best non - invasive method to diagnose the acute obscure bone injury.

关 键 词：膝关节 创伤 磁共振成像 关节镜 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]