腕骨脱位影像诊断中若干问题探讨  

Discussion on Some Problems in Imaging Diagnosis of Carpal Dislocation

作　　者：刘文银[1] 马永强[1] 孟现平[1] 胡效坤[2] 

机构地区：[1]山东大学齐鲁医院平邑分院放射科,临沂273300 [2]青岛大学附属医院介入医学中心,青岛266011

出　　处：《临床放射学杂志》2015年第3期427-430,共4页Journal of Clinical Radiology

摘　　要：目的探讨腕骨脱位的分型及命名、骨折与脱位的关系及其影像学检查方法。方法 56例腕骨脱位患者均摄有腕关节正侧位片,其中16例行64排CT扫描及重组;综合分析影像表现并进行诊断分型。结果月骨脱位9例,月骨周围脱位19例,经舟骨月骨周围脱位16例,月骨和半舟骨脱位2例,舟骨-月骨周围脱位1例,其他腕骨脱位9例。其中34例伴有至少一处撕脱骨折。16例行平片及CT检查,平片显示撕脱骨折8例12处,未明确骨折部位2处,漏诊豆状骨脱位1例;CT示撕脱骨折11例21处,对骨折部位及脱位诊断均正确。结论腕骨脱位类型多而复杂,应根据脱位及骨折具体情况进行分型及命名。除脱位外应注意骨折的诊断及骨折与脱位的关系。对于较复杂的骨折脱位CT扫描及重组应作为常规检查。Objective To discuss the classification and naming of carpal dislocation,the relationship between fracture and dislocation and its imaging examination.Methods A total of 56 patients with carpal dislocation were included in this study.Both anteroposterior and lateral radiography of the wrist joint were employed in all patients.Additional 64-slice spiral CT scanning with image reconstruction was performed in 16 cases.Imaging findings were comprehensively analyzed and the classification of carpal dislocation was suggested.Results Of the 56 cases,lunate dislocation was confirmed in 9,perilunar dislocation in 19,trans-scaphoid perilunar dislocation in 16,lunate and partial scaphoid dislocation in 2,caphoid-perilunar dislocation in one and other types of carpal dislocation in 9.Among the 56 patients,avulsion fracture at least at one site was observed in 34.Sixteen patients underwent both radiography and CT examination.Radiography displayed 12 avulsion fractures in 8 cases and 2 un-identified avulsion fractures; missed diagnosis of pisiform dislocation was seen in one case.CT scan revealed 21 avulsion fractures in 11 cases; all the diagnoses of fractures and dislocation judged by CT were correct.Conclusion The types of carpal dislocation are multiple and complex,the typing and naming should be based on the specific conditions of dislocation and fracture.In addition to dislocation,attention should also be paid to the relationship between the fracture and dislocation.For more complex fractures dislocation,CT scan together with image reconstruction should be used as a routine examination.

关 键 词：腕关节 腕骨 月骨 骨折 脱位 

分 类 号：R816.8[医药卫生—放射医学]