腕三角纤维软骨复合体损伤的MRI诊断  

The MRI diagnosis of triangular fibrocartilage complex injures in the wrist

作　　者：万梦楠 周胜法[2] 林锋[2] 陈久尊[2] 何家维[2] 郑显秋 

机构地区：[1]浙江省温州市瓯海区第三人民医院放射科,浙江温州325000 [2]温州医科大学附属第二医院放射科,浙江温州325000

出　　处：《医学影像学杂志》2016年第1期87-90,共4页Journal of Medical Imaging

基　　金：温州市科技局科技项目(Y20130218);温州市瓯海区科技发展计划项目(20143001)

摘　　要：目的探讨3.0T MRI在腕关节三角纤维软骨复合体(TFCC)损伤中的价值。方法回顾性分析26例TFCC损伤的MRI及X线平片、CT表现。结果 26例X线检查13例阴性,5例茎突骨折,2例桡骨远端骨折,2例月骨坏死,6例尺骨径突阳性征。5例多层螺旋CT扫描,发现骨折或/和骨坏死2例。26例MRI检查中,21例诊断TFCC损伤,其中包括TFCC撕裂或穿孔8例,主要表现为在MRI脂肪抑制序列(STIR)、2D MERGE及T2WI上点状、条片状高信号,在T1WI序列上呈等信号;9例腕部骨折(包括尺骨茎突5例,桡骨2例,腕骨2例);3例三角骨或月骨坏死;8例尺桡骨或腕骨挫伤;10例腕关节腔积液。结论 TFCC形态细小而不规则,损伤时X线平片和CT检查价值有限,MRI多序列多方位薄层图像对显示其损伤及邻近骨质病变有重要价值。Objective To investigate the value of 3.0 T MRI in triangular fibrocartilage complex （TFCC） injures in the wrist. Methods The MRI, X-ray and CT characteristics of 26 cases of TFCC injuries were analyzed retrospectively. Results Of the 26 cases with X-ray examination, 13 were negative cases, 5 ulnar styloid fracture, 2 distal radial fracture, 2 lunate necrosis and 6 positive ulnar styloid. 5 cases underwent multi-slice CT scan, of which 2 cases had fracture or/and necrosis, others hadn＇ t abnormal sign. Of the 26 patients underwent MRI examination, 21 cases were diagnosed as TFCC injuries including 8 cases with TFCC tear or perforation which were mainly spotty and stripped hyperintense on MRI short time inverse recovery （STIR）, 2DMERGE and T2WI and isointense on T1WI; 9 were wrist fracture （5 ul/aar styloid, 2 radius and 2 wrists） ; 3 were triangular bone or lunate necrosis; 8 were radius and ulna or wrist contusion and 10 wrist joints effusion. Bone contusion was long T1 and long T2 , including bone fracture with bone trabecular or bone cortex breaking. Conclusion The value of X-ray and CT examination for TFCC injuries is limited, as the morphology of TFCC is tiny and irregular. MRI with multiple sequences and multiple positions thin slice images play significant value for TFCC injuries and neighbor bone lesions.

关 键 词：三角纤维软骨复合体 损伤 磁共振成像 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]