外伤后膝关节骨挫伤磁共振成像的评价  

Value of MRI in diagnosis of bone contusion of knee joint

作　　者：宋扬[1] 金银华[1] 

机构地区：[1]吉林省吉林石化总医院(北华大学第二附属医院)二院影像科,132022

出　　处：《中国临床研究》2010年第4期275-276,共2页Chinese Journal of Clinical Research

摘　　要：目的探讨磁共振成像(MRI)对外伤后骨挫伤的诊断价值。方法急性外伤性膝关节骨挫伤病例42例,X线平片检查均为阴性结果。均于外伤后5d内使用东芝TOSHIBAExcelART1.5T超导磁共振机,膝关节四通道正交线圈,分别进行10°～15°斜矢状面扫描及冠状面T2WI、T1WI及T2WI脂肪抑制序列扫描。结果42例中,单发骨挫伤22例,多发骨挫伤20例。16例合并韧带损伤,39例有膝关节腔积液,合并隐匿性骨折4例。MRI共显示108处病灶,其MRI表现为斑片状、地图状异常信号,T1WI呈低信号,T2WI呈稍高信号,边界模糊,T2WI脂肪抑制序列呈高信号,边界清。出现MRI"对吻"征表现者6例。4例隐匿性骨折病例可见T2WI脂肪抑制序列中清晰锐利的细线状高信号,达关节下软骨面。结论MRI对于膝关节外伤后骨挫伤的诊断具有重要价值。Objective To assess the value of MRI in diagnosis of bone contusion of knee joint.Methods A total of 42 patients with acute knee joint injuries from Juanury 2007 to December 2007 whose X-ray radiographs were negtive results received MRI examination.Among them,there were 29 case male and 13 female（ages 13-70,average 38.8 year old）.All patients were examined by MRI within 5 days after injury.TOSHIBA Excel ART 1.5T MRI was performed for knee coil 10°-15° oblique sagittal scan and coronal scan with T2-weighted images（T2WI）,T1-weighted images（T1WI）and T2WI with fat suppressed sequence.Results In 42 patients with bone contusion of knee joint injuries,22 cases were simple bone contusion,and 20 cases were multiple bone contusion.Among them,16 case complicated with ligament injury;39 cases complicated with hydrops of articular cavity;4 cases complicated with occult fracture.A total of 108 foci were revealed.The characteristics of MRI were to appear patchy geographic regeons of abnormal signal intensity.T1WI appeared low signal intensity and T2WI appeared higher signal intensity,and their margins were poorly defined.T2WI with fat suppressed sequence appeared high intensity,and the margin was well defined.Six cases appeared ＂Kissing＂ sigh.Four cases of occult fractures showed linear high signal intensity in T2WI with fat suppressed sequence extending to the inferior articular cartilage surface.Conclusions MRI is very important in the diagnosis of bone contusion of knee joint.

关 键 词：膝关节 骨挫伤 磁共振成像 

分 类 号：R683[医药卫生—骨科学] R445.2[医药卫生—外科学]