齿状突急性骨折骨髓水肿的变异性研究  

Marrow edema variability study in acute odontoid fractures

作　　者：邹珍 李江平 喻汉华 金辉 彭俊红 ZOU Zhen;LI Jiang-ping;YU Han-hua(Department of Radiology,the Fourth Hospital of Wuhan City,Wuhan 430000,China)

机构地区：[1]武汉市第四医院放射科,湖北武汉430000 [2]海南省人民医院放射科,海南海口570311

出　　处：《放射学实践》2024年第8期1089-1092,共4页Radiologic Practice

摘　　要：目的:探讨急性齿状突骨折患者局部骨髓水肿程度与骨折断端分离情况的相关性。方法:回顾性分析2010年10月-2023年10月在本院行CT及MRI检查的35例急性齿状突骨折患者的临床和影像资料。按照骨折断端分离情况将患者分为2组:牵张组(11例)及未牵张组(24例)。基于MRI表现,将骨髓水肿程度分为4级(1~4分)。采用秩和检验比较两组患者骨髓水肿程度的差异。结果:35例中,19例患者可见骨髓水肿,在压脂STIR序列MRI图像上可见局部骨髓呈明显高信号改变,在CT图像上可见邻近骨皮质断裂;余16例患者未出现明显骨髓水肿,即STIR序列上骨髓内未见明显高信号。两组患者骨髓水肿程度的差异有统计学意义(Z=2.86,P=0.01<0.05),牵张组骨髓水肿程度低于未牵张组。结论:急性齿状突骨折患者在MRI上可无明显骨髓水肿表现,这与传统的影像学观念不同,尤其是骨折断端分离时,容易导致漏诊,在MRI阅片时应该提高警惕,需结合CT表现、临床病史及MRI上其它软组织损伤情况等进行综合分析。Objective:To investigate the correlation between the degree of local bone marrow edema and the separation of broken ends in patients with acute odontoid fracture.Methods:The clinical and imaging data of 35 patients with acute odontoid process fracture who underwent CT and MRI examination in our hospital from October 2010 to October 2023 were analyzed retrospectively.Accor-ding to the separation of the broken ends of the fracture,the patients were divided into two groups:distraction group(n=11)and non-distraction group(n=24).Based on the MRI findings,the degree of bone marrow edema was divided into 4 grades(1~4 points).Rank sum test was used to compare the degree of bone marrow edema between the two groups.Results:Among the 35 cases,19 patients showed bone marrow edema,the main feature was with regional high signal intensity in bone marrow on STIR sequence MR images,and the bone cortex rupture could be found on CT images,while no obvious bone marrow edema was found in the other 16 patients.There was significant difference in the degree of bone marrow edema between the two groups(Z=2.86,P=0.01<0.05).The degree of bone marrow edema in the distraction group was lower than that in the control group.Conclusion:Patients with acute odontoid fracture have no obvious bone marrow edema on MRI,which is different from the traditional imaging concept,especially when the fracture ends are separated,it is easy to lead to missed diagnosis.Pay more attention when reading MRI images,and to make comprehensive analysis should be made in combination with CT manifestations,clinical history and other soft tissue injuries on MRI.

关 键 词：齿状突骨折 骨髓水肿 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814.42[医药卫生—诊断学] R683.2[医药卫生—临床医学]