急性骨髓炎的早期MRI诊断价值  

Early diagnostic value of MR imaging in acute supparative osteomyelitis

作　　者：李方元 孙志群[2] 孙博 秋鹏 王富娟 田军 LI Fangyuan;SUN Zhiqun;SUN Bo;QIU Peng;WANG Fujuan;TIAN Jun(Department of Medical Imaging, Jinan Nanjiao Hospital, Jinan 250002, P.R.China;Epartment of Neonatology, Weifang People's Hospital, Weifang 261000, P.R.China;Department of Medical Imaging, Shandong Provicial Hospital Affilited to Shandong First Medical Univesity, Jinan 250021, P.R.China)

机构地区：[1]山东省济南南郊医院影像科,山东济南250002 [2]山东省潍坊市人民医院新生儿科,山东潍坊261000 [3]山东第一医科大学附属省立医院医学影像科,山东济南250021

出　　处：《医学影像学杂志》2021年第11期1952-1955,1974,共5页Journal of Medical Imaging

摘　　要：目的探讨MRI在急性化脓性骨髓炎早期诊断中的应用价值,为临床早期诊断及治疗提供依据。方法对17例急性化脓性骨髓炎患者于发病后3~14天均行MRI检查,其中12例行X线摄影检查,5例行CT检查。结果12例X线摄影结果显示发病10天内均无异常发现,14天2例可见干骺端骨质模糊、稀疏;5例CT结果显示,1例发病7天内无异常发现,4例发病10天后可见干骺端骨密度降低,骨小梁模糊,周围肌间脂肪间隙模糊或消失;MRI结果显示发病3~4天后骨髓内可见异常信号,表现为片状T_(1)WI稍低信号、FS-T_(2)WI均匀高信号,5~7天可见不均匀斑点状和蜿蜒迂曲的条状混杂信号以及骨膜水肿,8~14天可见粗大的迂曲管条状等低T_(1)WI和等高T_(2)WI信号,骨膜下脓肿形成。结论急性骨髓炎早期3~4天时MRI即有异常表现,表现为骨髓水肿,约1周后出现斑点状和迂曲管条状混杂信号颇具特征,能为诊断提供可靠依据。Objective To explore the application value of MRI in the early diagnosis of acute suppurative osteomyelitis,and to provide basis for clinical early diagnosis and treatment.Methods Seventeen patients with acute suppurative osteomyelitis underwent X-ray plain film,CT and MRI in 3~14 days after onset.Results No abnormal findings were observed on X-ray plain film within 10 days of onset.On 14 days,2 cases showed blurred and sparse metaphyseal bone.In 5 cases of CT,1 case had no abnormal findings within 7 days of onset,4 cases had decreased metaphyseal bone density,blurred bone trabeculae and blurred or disappeared peripheral intermuscular fat space after 10 days.MRI findings showed that abnormal signals could be seen in the bone marrow 3~4 days after the onset,which showed patchy slightly low signal on T_(1)WI and uniform high signal on FS-T_(2)WI.Uneven spotted and winding strip mixed signals and periosteal edema could be seen on 5~7 days.Thick tortuous tube strip and other low T_(1)WI and equal high T_(2)WI signals could be seen on 8~14 days,and subperiosteal abscess was formed.Conclusion There are abnormal MRI manifestations in the early stage of 3~4 days of acute osteomyelitis,which is characterized by bone marrow edema.About a week later,there are mottled and tortuous tubular mixed signals,which can provide a reliable basis for diagnosis.

关 键 词：急性化脓性骨髓炎 磁共振成像 X线摄影 体层摄影术 X线计算机 

分 类 号：R574[医药卫生—消化系统] R814[医药卫生—内科学]