64层CT及MRI诊断隐匿性骨折的临床价值  

Clinical Value of Multi-slice Spiral CT and MRI in Diagnosing Occult Fracture

作　　者：丁建林[1] 易旦冰[2] 陈晓亮[1] 梁立华[1] 陈耀强[1] 

机构地区：[1]广东医学院附属深圳福田人民医院、深圳市第四人民医院放射科,深圳518033 [2]广东医学院附属深圳福田人民医院、深圳市第四人民医院手术室,深圳518033

出　　处：《中国医学影像学杂志》2009年第1期12-15,共4页Chinese Journal of Medical Imaging

摘　　要：目的:探讨多层CT及MRI诊断隐匿性骨折的临床价值。材料和方法:回顾性分析经DR检查阴性而64层CT或MRI诊断骨折的51例外伤患者的多层CT及MRI表现。51例均行64层CT检查,28例同时行MRI检查。结果:64层CT显示骨皮质/骨小梁中断47例(47/51)。22例(22/28)MRT1WI见骨皮质下或松质骨内不规则线状、条状低信号带,T2WI对应于T1WI低信号带仍可见形态相似的低信号;28例(28/28)MRT2WI对应于T1WI低信号带或64层CT显示的骨折线周围均见片状高信号水肿;6例(6/28)MRT1WI未见低信号带,64层CT显示骨皮质中断;4例(4/28)MRT1WI见松质骨内低信号带,64层CT检查未明确骨折线。结论:多层CT显示骨皮质细微骨折优于MRI,可作为隐匿性骨折的首选检查方法;MRI对部分多层CT显示不明确的松质骨骨折的诊断有帮助。Purpose： To investigate the clinical value of muhi-slice spiral CT and MR imaging in diagnosing occult fracture. Materials and Methods： Fifty-one patients with acute trauma had normal radiographic results and （M-slice CT or MR imaging showed fracture. All 51 patients were studied using 64-slice CT and 28 patients also underwent MR imaging examinations. The images of 64-slice CT and MRI were analyzed. Results： 64-slice CT clearly demonstrated fractures of cortical bone or trabecular bone in 47 cases. MR imaging demonstrated irregular linear or speckled low signal intensity in the subcortical regions or trabecular bone regions in 22 cases on T1WI and analogous low signal intensity were seen in corresponding areas on T2WI, and high signal intensity changes around linear or speckled low signal intensity on T1WI or fracture on （M-slice CT were seen in all 28 cases on T2WI. MR imaging showed no linear or speckled low signal intensity on T1WI but 64-slice CT scanning demonstrated fracture of cortical bone in 6 cases, while MR imaging demonstrated irregular linear or speckled low signal intensity in the trabecular bone regions but 64-slice CT scanning showed no fracture signs in 4 cases. Conclusions ： Multi-slice spiral CT is superior to MR imaging in displaying microfracture of cortical bone and it is the best method in diagnosing occult fracture. MR imaging is helpful for fractures of trabecular bone which multi-slice spiral CT can not diagnose definitely.

关 键 词：隐匿性骨折 CT MRI 

分 类 号：R816.8[医药卫生—放射医学]