平片与MRI在胫骨髁间隆突撕脱性骨折中的诊疗价值  

X-ray and MRI diagnostic value of avulsion fracture in intercondylar eminence of tibia

作　　者：张礼鹃[1] 黎加识[1] 李培[1] 涂昌灼[1] 吴光任[1] 

机构地区：[1]广东省东莞市虎门医院,523902

出　　处：《影像诊断与介入放射学》2008年第4期179-181,共3页Diagnostic Imaging & Interventional Radiology

摘　　要：目的评价 X 线平片与 MRI 检查对胫骨髁间隆突撕脱性骨折的诊疗价值。方法回顾性分析32例胫骨髁间隆突撕脱性骨折患者 X 线及 MRI 影像资料,所有骨折病例均经关节镜证实。X 线摄片采用膝关节正侧位,部分加摄斜位;MRI 检查采用横断位 FSE-T_2WI,斜矢状位 SE-T_1WI、FSE-T_2WI、STIR 及冠状 FSE-T_2WI、梯度回波脂肪抑制序列扫描,检查时患者取仰卧位。结果 X 线平片确诊28例(87.5%),漏诊4例(12.5%);MR 确诊32例(100%);经 X 线确诊的患者中,MRI 检查均合并周围其他结构的损伤(28/28),其中交叉韧带损伤26例,半月板损伤7例,侧副韧带损伤4例,骨挫伤26例,其他部位的骨折6例;X 线漏诊的患者中,合并交叉韧带损伤3例,半月板损伤1例,骨挫伤2例。结论胫骨髁间隆突撕脱性骨折通常合并周围其他结构的损伤,经 X线平片确诊的病例可直接行关节镜诊疗;疑似髁间隆突骨折的患者应行 MR 检查,为临床诊疗提供有效的影像资料。Objective To evaluate the diagnostic value of X-ray and MRI of avulsion fracture in tibial intercondylar eminence. Methods X-ray and MRI images of 32 patients with avulsion fracture in tibial intercondylar eminence were retrospectively analyzed. All the cases were confirmed by arthroscopy. X-ray examinations were obtained from a standard anteroposterior and lateral views, part of them with oblique views. Axial FSE-T2WI, sagittal SE-T1WI, FSE-T2WI, STIR and coronal FSE-T2WI, GRE-STIR were examined in MRI examinations. Results X-ray showed 28 correct diagnoses （87.5%） and 4 occult fracture misdiagnosis （12.5%）, however, all the cases were correctly diagnosed with MRI（ 100% ）. In the patients which were correctly diagnosed by X-ray, MRI showed other lesions of knee joints （28/28）, including 26 cases cruciate ligament trauma, 7 cases meniscus trauma, 4 cases collateral ligament trauma, 26 cases bone-contusion, and 6 cases other fracture. In the patients which were missed diagnoses in X-ray examinations, 3 cases showed cruciate ligament trauma, 1 case showed meniscus trauma, and 2 cases showed bone-contusion in MRI. Conclusion Avulsion fracture in tibial intercondylar eminence were often associated with other knee joints lesions, which can be treated by arthroscopy directly if they were diagnosed by X-ray examinations. However, occult fractures should be examined by MRI, which can offer detailed information for clinic treatment.

关 键 词：胫骨髁间隆突 骨折 撕脱性 X线平片 磁共振成像 

分 类 号：R445.[医药卫生—影像医学与核医学] R683.42[医药卫生—诊断学]