早期大骨节病儿童手部MRI表现  

MRI Manifestation of Hands of Children with Early Stage Kaschin-Bech Disease

作　　者：钟洲[1] 马俊[1] 沈彬[1] 周宗科[1] 康鹏德[1] 杨静[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《华西医学》2013年第5期684-688,共5页West China Medical Journal

基　　金："十一五"国家科技支撑项目(2007BA125B04)~~

摘　　要：目的总结早期大骨节病儿童的手部MRI表现,为早期大骨节病诊断提供参考依据。方法 2009年11月-2011年12月对当地筛查出的18例6～12岁早期大骨节病患儿进行双手X线、MRI检查,并对比读片。结果所检18例大骨节病儿童的手部MRI异常主要表现为骺线不整、中断、变薄、信号改变、骺核信号改变等(29.0%)、干骺端先期钙化带与骨骺部分穿通(17.7%)等。按部位分手指近节(71.0%),中节(19.4%),远节(9.7%);干骺端为异常集中处(53.2%),其次为骨骺(46.8%),骨端无异常发现。另外MRI还能显示X线片不能显示的骺线、骺核微小形态、信号改变以及干骺端由骺板伸入指骨的中高信号影像(17.7%)等更早期的软骨病变的征象。结论 MRI较X线不仅能更清晰显示儿童大骨节病手指异常改变,而且能更早期发现更多的手指异常改变,但还需进一步随访观察。Objective To study the MRI manifestation of hands of 18 children with early stage Kaschin-Beck disease （KBD） aged between 6 and 12 years in Nanmuda Center School, Rongmuda Center School and Gaduo Center School of Rangtang County, Aba, Sichuan Province, in order to provide reference for treating the disease. Methods Between November 2009 and December 2011,18 children with KBD in its early stage were examined with X-ray and MRI examination for both hands. Radiographs were read by 14 specialists for diagnosis. Unusual symptoms were contrasted, counted and analyzed. Results The unusual symptoms in MRI radiographs contained unsmooth epiphyseal line, interrupted epiphyseal line, thinner epiphysial line, signal change of epiphysis （29.0%）, connected early calcification strip and the metaepiphysis and epiphysis （17.7%）. Unusual symptoms distributed in proximal phalanx （71%）, middle phalanx （19.4%）, and distal phalanx （9.7%）. Most unusual symptoms concentrated in metaepiphysis （53.2%）, followed by epiphysis （46.8%）. No unusual symptoms occurred in capitulum. Furthermore, MRI could display tiny changes of epiphyseal line and epiphysis in terms of form and signal. It could also display earlier abnormal changes of cartilage such as medium to high signal from epiphyseal plate into phalanx （17.7%）. Conclusion Compared with X-ray, MRI can display unusual symptoms more clearly and discover more unusual symptoms in earlier time in hands of children with KBD in its early stage, but this needs more follow-up and study.

关 键 词：大骨节病 手 儿童 X线 MRI 

分 类 号：R726.8[医药卫生—儿科]