MRI在儿童肘关节损伤中的应用  

Application of MRI in diagnosis of elbow joint injury in children

作　　者：李晓娜[1] 彭志刚[1] 张雪松[1] 王晓英[1] 孙英彩[1] 张英华[1] 赵利阳 张超 刘美荣[1] LI Xiaona;PENG Zhigang;ZHANG Xuesong(Department of CT,The Third Hospital of Hebei Medical University,Hebei, Shijiazhuang 050051, China)

机构地区：[1]河北医科大学第三医院CT室,石家庄市050051

出　　处：《河北医药》2020年第9期1344-1347,共4页Hebei Medical Journal

基　　金：河北省卫生和计划生育委员会指令性课题(编号:ZL20140025)。

摘　　要：目的通过分析儿童肘关节损伤的X线片与核磁共振(magnetic resonance imaging,MRI)图像,评价骨垢损伤情况,探讨MRI在儿童肘关节损伤中的应用。方法选取肘关节外伤患者87例,所有患者进行X线及MRI检查。X线平片行正侧位,MRI采用T1WI、T2WI、PDWI及STIR序列,冠状、矢状及轴面扫描。比较X线平片及MR检查结果,计算骨折的种类比例,分析各个骨骼骨骺骨折与年龄的关系及MRI相对于X线平片的优势作用。结果MRI诊断发现肘关节骨折患者83例,其中肱骨内上髁骨骺分离14例,肱骨外髁骨折11例,肱骨髁上骨折10例,肱骨远端全骨骺分离5例,肱骨内髁骨折2例,肱骨远端干骺端骨折6例,尺骨鹰嘴骨折15例,尺骨冠突骨折4例,桡骨头颈骨折9例,桡骨小头脱位4例,孟氏骨折3例。儿童最常见的肘关节骨折类型分别是尺骨鹰嘴骨折(18.07%)、肱骨内上髁骨骺分离(16.87%)、肱骨外髁骨折(13.25%)、肱骨髁上骨折(12.04%)及桡骨头颈骨折(10.84%),其中肱骨内上髁骨骺分离及尺骨鹰嘴骨折主要发生于4~12岁,发病高峰年龄均在8~11岁,肱骨髁上骨折、肱骨外髁骨折及桡骨头颈骨折主要发生于<7岁。与MRI检查比较X线平片漏诊6个,对骨折类型判断错误的8例,其中误诊最多的骨折是髁上骨折,易误诊为全骨骺分离。结论与X线平片比较,MRI能得到更多的信息,可以肘关节骨折的损伤做出正确的诊断,是儿童肘关节损伤的重要检查手段,可有效补充X线对儿童肘关节损伤诊断的不足。Objective To investigate the application value of MRI in diagnosis of elbow joint injury in children through the comparative analysis of X ray film and magnetic resonance imaging(MRI)to evaluate the severity of bone injury.Methods A total of 87children patients with elbow joint injury.All the patients underwent X-rays and MRI examination.The X-ray plain film was in the positive-lateral position,and the MRI used T1WI,T2WI,PDWI and STIR sequences with coronal,sagittal and axial scanning.The examination results of X-ray plain film and MRI were comparatively analyzed,and the fracture types,the correlation between bone epiphyseal fracture and age as well as the advantages of MRI as compared with those of X-ray plain film were observed and analyzed.Results MRI examination showed the elbow joint fractures in 83 patients,of whom,there were 14 cases of internal epicondyle of the humerus epiphyseal separation,11 cases of humerus lateral condyle fracture,10 cases of humeral supracondylar fracture,5 cases of humerus distal epiphyseal separation,2 cases of humerus condyle fracture,6 cases of humerus fractures of the distal stem epiphyseal end,15 cases of ulna olecranon fracture,4 cases of ulna coronoid process fractures,9 cases of radial head and neck fracture,4 cases of radial head dislocation,3 cases of monteggia fracture.The most common type of elbow joint fracture was ulna olecranon fractures(18.07%),humerus internal epicondyle epiphyseal separation(16.87%),humerus lateral condyle fracture(13.25%),the humerus condyle fracture(12.04%)and the radial head and neck fractures(10.84%),internal epicondyle of the humerus epiphyseal separation and ulna olecranon fracture mainly in children aged from 4 years to 12 years,and the incidence peak age was during 8 to 11 years,and the incidence of the humerus condyle fracture,humeral lateral condyle fractures and radial neck fracture mainly was in the children less than seven years.As compared with that by MRI examination,the misdiagnosis by X-ray plain film in 6 cases,and 8 cases of fra

关 键 词：肘关节 骨骺损伤 磁共振成像 

分 类 号：R814.46[医药卫生—影像医学与核医学]