X线片和磁共振及核素扫描在儿童大骨节病早期诊断中的应用研究  

X-ray, MRI and SPECT in early diagnosis of children Kashin-Beck disease

作　　者：马俊[1] 程兴旺[1] 钟洲[1] 邹翎[2] 戚忠智[3] 唐恭顺[3] 沈彬[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,四川省成都市610041 [2]四川大学华西医院放射科,四川省成都市610041 [3]四川大学华西医院核医学科,四川省成都市610041

出　　处：《中国骨与关节损伤杂志》2013年第11期1023-1025,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家"十一五"科技支撑项目(2007BAI25B04)

摘　　要：目的初步探讨大骨节病(KBD)儿童早期手部X线、高场强磁共振成像(MRI)及全身核素扫描(SPECT)的表现及分别在儿童KBD早期诊断中的价值。方法对四川省壤塘县KBD疫区筛查出的18例KBD儿童进行双手X线、MRI及SPECT检查,并对比阅片。总结儿童KBD早期手指指间关节的X线、MRI及SEPCT异常表现。结果 18例KBD儿童在X线片上显示出的异常表现均能在MRI中清楚呈现,表现为干骺端先期钙化带与骨骺部分穿通、干骺端先期钙化带凹陷、中断以及锥形骺;MRI还观察到如骺线中断、不整、变薄、信号强度改变以及干骺端由骺板伸入指骨的中高信号等X线无法显示的微小形态变化。所有儿童的全身核素骨显像,双手核素摄取率计算都未见确切异常。结论 MRI不仅能在形态学方面呈现与X线片一致,且更细微的儿童KBD早期手部异常改变,还能通过观察软骨信号变化提供软骨组织结构变化的病理生理信息,其在儿童KBD早期诊断中具有重要价值,而现有SPECT技术对儿童KBD早期诊断价值不大。Objective To investigate the imaging features and diagnostic value of X-ray, MRI and SPECT in the early stage of children with Kashin-Beck disease （KBD）. Methods A total of 18 children in early stages of KBD were selected by hands X- ray screening from the hit area of Rangtang county, Sichuan province. Everyone was examined with MRI and SPEPCT examination. The radiographs were read by 10 specialists to diagnose and compare the perfol^nance of the X-ray. Results The abnormalities of children in the X-ray could be clearly presented in the MRI, expressed as metaphyseal provisional calcification zone partial interlinked with epiphyses, cone-shaped epiphysis, depression and interruption of metaphyseal provisional calcification zone. MRI also observed the micro morphological changes which could not be displayed in X-ray, such as epiphyseal line interrupt, uneven, thinning, signal intensity changes and lots of intermediate or hyperintensity from epiphyseal plate extends into the phalanx in the metaphysic. There was no definite exception in SPECT and the radionuclide uptake ratio of hands. Conclusion MRI can not only present the same, even more subtle abnormalities in terms of morphology than X- ray, but also provide pathophysiological information of cartilage tissue structural changes by signal intensity changes in cartilage. So, MRI has important value in early diagnosis of children KBD, while the value of SPECT technology is little.

关 键 词：大骨节病 儿童 X线片 磁共振成像 核素扫描 

分 类 号：R684.1[医药卫生—骨科学]