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1.
Stallenberg B Rommens J Legrand C de Maertelaer V Metens T Alain Gevenois P 《Skeletal radiology》2001,30(1):31-38
Objective. To evaluate the supraspinatus muscle radiodensity on the outlet view as an indication of a tendon tear.
Design and patients. Plain radiographs and magnetic resonance imaging (MRI) examinations were obtained on both shoulders of 40 subjects aged
23–70 years, including 13 asymptomatic volunteers and 27 patients. Two readers analyzed the superior contour and the heterogeneity
of the supraspinatus muscle radiodensity and compared them with the MRI findings.
Results and conclusion. Significant concordances (P<0.001) were found between the assessments of the superior contour and the heterogeneity of the muscle radiodensity, respectively,
on plain radiographs and MR images. For the diagnosis of a full-thickness tear, the analysis of the superior contour and the
heterogeneity of the muscle radiodensity reached an accuracy of 85% and 80% respectively. Stepwise discriminant analyses showed
low to moderate benefit of considering the contour and the heterogeneity simultaneously. The inter- and intraobserver agreement
ranged from moderate to good. We conclude that on the outlet view, modifications in the superior contour and heterogeneity
of the supraspinatus muscle radiodensity suggest a full-thickness tear.
Received: 6 December 1999 Revision requested: 6 March 2000 Revision received: 5 June 2000 Accepted: 4 October 2000 相似文献
2.
Objective. To assess whether an association exists between patellar tendinosis and abnormal patellar tracking. Design and patients. The MRI examinations of 630 patients (i.e. 860 knees) referred with anterior knee pain over a 4-year period were assessed
in retrospect for the presence of patellar tendinosis and abnormal patellar tracking. The images of the patients with patellar
tendinosis were reviewed and the location within the patellar tendon was recorded. Results. There were 44 knees with proximal patellar tendinosis. Twenty-four of these were considered to have normal patellar tracking
and 20 to have abnormal patellar tracking. In the group of 816 knees without proximal patellar tendinosis, 581 were considered
to have normal patellar tracking and 235 knees to have abnormal patellar tracking. When the two groups were compared there
was a statistically significant difference in the ratio of patients with and without abnormal tracking. Conclusion. In patients referred with anterior knee pain or suspected abnormal patellar tracking there is a significant association
between proximal patellar tendinosis and abnormal patellar tracking.
Received: 3 June 1998 Revision requested: 4 August 1998; 16 November 1998 Revision received: 9 November 1998; 18 January 1999
Accepted: 29 January 1999 相似文献
3.
Sheri L. Albers Charles E. Spritzer William E. Garrett Jr. William C. Meyers 《Skeletal radiology》2001,30(5):270-277
Objective. To describe the MR findings in athletes with pubalgia.
Design and patients. Pelvic MR images of 32 athletes (30 men, 2 women) with pubalgia were studied. T1-weighted and T2-weighted (SE and FSE) and
STIR images in the axial and coronal planes were obtained on a 1.5-T system. Images were reviewed for general pelvic pathology.
Special attention was given to the pubic symphysis, groin and pelvic musculature, and to the abdominal wall musculature.
Results. Thirty surgically confirmed cases comprise the study group. Abnormalities in the following were found: pubic symphysis (21/30),
abdominal wall (27/30), groin musculature, including rectus abdominis (21/30), pectineus (6/30), and adductor muscle group
(18/30).
Conclusions. Pubalgia is a complex process which is frequently multifactorial. The MRI findings can alter the surgical approach.
Received: 19 May 2000 Revision requested: 27 July 2000 Revision received: 6 October 2000 Accepted: 27 November 2000 相似文献
4.
Alice Poon-Chue Lawrence Menendez Mary Melissa Gerstner Patrick Colletti Michael Terk 《Skeletal radiology》1999,28(5):279-282
Objective. To define the spectrum of MRI appearances of postoperative seromas in patients who have undergone excision of extremity
soft tissue sarcomas. Local recurrence is always of concern; often a second-look procedure is performed to assess this possibility.
Unnecessary surgical exploration may be avoided if radiologists and orthopedic oncologists are familiar with this spectrum
of MRI appearances. Design and patients. The medical records and images of 85 patients with extremity soft tissue sarcomas were reviewed. Postoperative MRI examinations
were available in 46 patients. Eight of these demonstrated MRI evidence of postoperative seroma. The initial size, rate of
change, margin, and internal architecture of each seroma was measured, calculated, graded, and graphed. Results and conclusion. MRI is an excellent modality for the evaluation of postoperative seromas. Globular areas of low to intermediate signal material
within seromas may represent organized hematomas or granulation tissue rather than sarcoma recurrence. Local recurrence rarely
occurs within seromas.
Received: 12 November 1998 Revision requested: 22 January 1999 Revision received: 2 February 1999 Accepted: 22 February 1999 相似文献
5.
An assessment of the effectiveness of magnetic resonance imaging of the shoulder: literature review 总被引:2,自引:0,他引:2
Objective. To analyse and compare all papers published to date (August 2000) that quantify the effectiveness, defined as the impact
of clinician’s diagnosis or management plans, or patient outcome, of MRI of the shoulder.
Design. A computerised search of Index Medicus with a broad search strategy relating to shoulder MRI was performed. Manual assessment
of all papers listed was undertaken with classification of each paper depending on whether it addressed questions of (1) technical
performance, (2) diagnostic performance or (3) outcome.
Results. Four of 265 qualifying papers addressed aspects of effectiveness and these were reviewed. The impact on the clinician’s
diagnosis varied widely between papers: the primary diagnosis was altered in 23% to 68% of cases, and the management plans
were subsequently changed in 15% to 61% of cases. Only one paper addressed the impact on patient health.
Conclusions. The effectiveness of MRI of the shoulder depends on the clinical skills of the referring clinician and prevalence of disease
in the study population. This will have implications when the effectiveness of an imaging technique between different institutions
is compared, and this in turn will influence any comparisons of cost-effectiveness.
Received: 22 October 1999 Revision requested: 31 January 2000 Revision received: 21 August 2000 Accepted: 24 August 2000 相似文献
6.
Poll LW Koch JA vom Dahl S Sarbia M Niederau C Häussinger D Mödder U 《Skeletal radiology》2000,29(1):15-21
Objective. To investigate the frequency and morphology of extraosseous extension in patients with Gaucher disease type I.
Design and patients. MRI examinations of the lower extremities were analyzed in 70 patients with Gaucher disease type I. Additionally, the thoracic
spine and the midface were investigated on MRI in two patients.
Results. Four cases are presented in which patients with Gaucher disease type I and severe skeletal involvement developed destruction
or protrusion of the cortex with extraosseous extension into soft tissues. In one patient, Gaucher cell deposits destroyed
the cortex of the mandible and extended into the masseter muscle. In the second patient, multiple paravertebral masses with
localized destruction of the cortex were apparent in the thoracic spine. In the third and fourth patient, cortical destruction
with extraosseous tissue extending into soft tissues was seen in the lower limbs.
Conclusions. Extraosseous extension is a rare manifestation of Gaucher bone disease. While an increased risk of cancer, especially hematopoietic
in origin, is known in patients with Gaucher disease, these extraosseous benign manifestations that may mimic malignant processes
should be considered in the differential diagnosis of extraosseous extension into soft tissues. A narrow neck of tissue was
apparent in all cases connecting bone and extraosseous extensions.
Received: 19 July 1999 Revision requested: 8 September 1999 Revision received: 7 October 1999 Accepted: 14 October 1999 相似文献
7.
Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis 总被引:2,自引:0,他引:2
Akira Ogose Tetsuo Hotta Tetsuro Morita Soichiro Yamamura Noboru Hosaka Hiroto Kobayashi Yasuharu Hirata 《Skeletal radiology》1999,28(4):183-188
Objective. To distinguish between benign and malignant tumors in the peripheral nerves. Design and patients. The clinical, imaging and histologic findings of 99 benign and 16 malignant tumors in the peripheral nerves were reviewed
retrospectively. Results. Preoperative motor weakness was observed in only six of 99 benign tumors and was mild, while slight to severe motor weakness
was present in 15 of 16 malignant lesions. Pain at rest was present in five of 99 benign tumors and in 15 of 16 malignant
tumors. All benign lesions showed a smooth tumoral margin, while half the malignant lesions showed an invasive margin on CT
or MRI. Thirteen of 28 benign lesions on CT and nine of 23 on MRI showed round to geographic central enhancement, but this
pattern was not seen in malignant lesions. Conclusion. Absence of severe motor weakness and a central enhancement pattern strongly suggest a benign nature, while severe rest pain
and invasive tumor margin suggest malignant lesions in peripheral nerve tumors.
Received: 30 July 1998 Revision requested: 30 October 1998 Revision received: 30 November 1998 Accepted: 12 January 1999 相似文献
8.
The radiological findings in chronic expanding hematoma 总被引:4,自引:0,他引:4
T. Aoki Hajime Nakata Hideyuki Watanabe Hironobu Maeda Toshihiro Toyonaga Hiroshi Hashimoto Toshitaka Nakamura 《Skeletal radiology》1999,28(7):396-401
Objective. To identify the characteristic MRI findings of chronic expanding hematoma correlated with the pathology.
Design and patients. Three patients who had a chronic expanding hematoma involving the musculoskeletal system were reviewed retrospectively.
Results and conclusion. Huge soft tissue masses suggestive of malignancy with destruction of the bony structure were revealed on radiography and
computed tomography. MRI showed the masses to exhibit heterogeneous signal intensity on both T1- and T2-weighted images with
a peripheral rim of low signal intensity, reflecting the central zones of fluid collection due to fresh and altered blood
with a wall of collagenous fibrous tissue. These MRI findings were seen in all three patients and are considered to be characteristic;
they assist in differentiation from neoplasm in consideration of the history of trauma or surgery.
Received: 11 December 1998 Revision requested: 19 April 1999 Revision received: 21 May 1999 Accepted: 27 May 1999 相似文献
9.
M. A. Bredella P. F. J. Tirman R. C. Fritz T. K. Wischer A. Stork H. K. Genant 《Skeletal radiology》1999,28(10):567-572
Objective. To investigate the use of MR imaging in the characterization of denervated muscle of the shoulder correlated with electrophysiologic
studies.
Design and patients. We studied with MR imaging five patients who presented with shoulder weakness and pain and who underwent electrophysiologic
studies. On MR imaging the distribution of muscle edema and fatty infiltration was recorded, as was the presence of masses
impinging on a regional nerve.
Results. Acute/subacute denervation was best seen on T2-weighted fast spin-echo images with fat saturation, showing increased SI related
to neurogenic edema. Chronic denervation was best seen on T1-weighted spin-echo images, demonstrating loss of muscle bulk
and diffuse areas of increased signal intensity within the muscle. Three patients showed MR imaging and electrophysiologic
findings of Parsonage Turner syndrome. One patient demonstrated an arteriovenous malformation within the spinoglenoid notch,
impinging on the suprascapular nerve with associated atrophy of the infraspinatus muscle. The fifth patient demonstrated fatty
atrophy of the teres minor muscle caused by compression by a cyst of the axillary nerve and electrophysiologic findings of
an incomplete axillary nerve block.
Conclusion. MR imaging is useful in detecting and characterizing denervation atrophy and neurogenic edema in shoulder muscles. MR imaging
can provide additional information to electrophysiologic studies by estimating the age (acute/chronic) and identifying morphologic
causes for shoulder pain and atrophy.
Received: 5 May 1999 Revision requested: 22 July 1999 Revision received: 28 July 1999 Accepted: 29 July 1999 相似文献
10.
Imaging of acute injuries of the articular surfaces (chondral, osteochondral and subchondral fractures) 总被引:7,自引:0,他引:7
Klaus Bohndorf 《Skeletal radiology》1999,28(10):545-560
Fractures involving the articulating surfaces of bone are a common cause of chronic disability after joint injury. Acute fractures
of the articular surface typically run parallel to the surface and are confined to the cartilage and/or the immediate subchondral
cancellous bone. They should be distinguished from vertical or oblique bone fractures with intra-articular extension. This
article reviews the mechanism of acute articular surface injuries, as well as their incidence, clinical presentation, radiologic
appearance and treatment. A classification is presented based on direct inspection (arthroscopy) and imaging (especially
MRI), emphasizing the distinction between lesions with intact (subchondral impaction and subchondral bone bruises) and disrupted
(chondral, osteochondral lesions) cartilage. Hyaline cartilage, subchondral bone plate and subchondral cancellous bone are
to be considered an anatomic unit. Subchondral articular surface lesions, osteochondral fractures and solely chondral fractures are different manifestations of impaction injuries that affect the articulating surface. Of the noninvasive imaging
modalities, conventional radiography and MRI provide the most relevant information. The appropriate use of short tau inversion
recovery, T1-weighted and T2-weighted (turbo) spin-echo as well as gradient-echo sequences, enables MRI to classify the various
acute articular surface lesions with great accuracy and provides therapeutic guidance.
Received: 5 April 1999 Revision requested: 6 May 1999 Revision received: 21 June 1999 Accepted: 12 July 1999 相似文献
11.
Objective. Although the popliteomeniscal fascicles are important stabilizers of the lateral meniscus, there have been few studies of
their MR appearance. We wished to determine: (1) whether the fascicles are normally seen on MR imaging, and (2) whether certain
imaging factors influenced their visualization.
Design and patients. We reviewed the sagittal MR images of 66 consecutive patients who had no evidence of injury to the lateral compartment. We
determined the frequencies of MR visualization of the superior and inferior popliteomeniscal fascicles, and whether visualization
was affected by the weighting of spin echo sequences, the presence of a joint effusion, slice placement relative to the
fascicles, and windowing of the images.
Results and conclusions. Both popliteomeniscal fascicles were seen in 64 of the 66 patients. The fascicles were better seen on T2-weighted images
than on proton-density weighted images (P<0.01). On the T2-weighted images, fascicle visualization was not significantly affected by the presence or absence of an
effusion, slice placement or image windowing (P=0.2 to 1.0). On proton-density weighted images, fascicle visualization was significantly improved when high-contrast windowing
was used (P=0.04). In conclusion, we found that the popliteomeniscal fascicles are normally seen on MR imaging of the knee when there
are no lateral compartment injuries. The fascicles are significantly better visualized on T2-weighted than on proton-density
weighted images. Visualization is not significantly affected by the presence of an effusion or slice placement.
Received: 3 May 1999 Revision requested: 17 June 1999 Revision received: 19 July 1999 Accepted: 29 July 1999 相似文献
12.
Muscle hernias of the lower leg: MRI findings 总被引:1,自引:0,他引:1
Muscle hernias of the lower leg involving the tibialis anterior, peroneus brevis, and lateral head of the gastrocnemius were
found in three different patients. MRI findings allowed recognition of herniated muscle in all cases and identification of
fascial defect in two of them. MR imaging findings and the value of dynamic MR imaging is emphasized.
Received: 1 March 1999 Revision requested: 24 March 1999 Revision received: 19 April 1999 Accepted: 20 April 1999 相似文献
13.
Purpose. In a patient with internal derangement of the shoulder, the diagnostic method of choice is controversial. Conventional arthrography
can diagnose most rotator cuff tears accurately; however, in many institutions MR arthrography is usually necessary to diagnose
labral tears. We utilized decision tree methodology to compare the cost- effectiveness of conventional arthrography and conventional
MRI with a hypothetical algorithm in which a patient underwent arthrography, performed with admixed gadolinium, which if negative,
was followed by MRI.
Design. The use of double-contrast arthrography alone, conventional MRI alone, and gadolinium-enhanced MRI used as an adjunct to
conventional arthrography were modeled for the diagnosis of full-thickness rotator cuff tears (RCT), partial RCTs, labral
tears, and the absence of cuff/labral tears using decision analysis methodology. English language medical publications were
searched to determine the base probabilities for the accuracy of the diagnostic tests. The outcome utilities ranged from –1
to +1 to reflect the value of correct diagnostic evaluation. Charges for diagnostic tests and appropriate surgical treatments
were based on 1997 Medicare reimbursement rates for professional fees and hospital charges in an outpatient setting. Sensitivity
analyses were performed to evaluate the effects of uncertainty regarding the prevalence of each disease state and the accuracy
of several diagnostic tests.
Results. In the base-case analysis, the average effectiveness of double-contrast arthrography alone, MRI alone and arthrography selectively
followed by MRI were 0.6610, 0.6715, and 0.7204, respectively. The average costs for each of these strategies were $1090,
$2033, and $2339, respectively.
Conclusion. Arthrography performed with admixed diluted gadolinium, which if negative is immediately followed by MRI, was somewhat more
expensive than conventional MRI. However, because of much greater effectiveness, cost-effectiveness was significantly higher
for our proposed algorithm. Conventional arthrography without gadolinium, although less expensive, had severely limited effectiveness.
Received: 4 June 1999 Revision requested: 6 August 1999 Revision received: 30 August 1999 Accepted: 1 September 1999 相似文献
14.
Nika Pusenjak Anton Grad Matej Tusak Matevz Leskovsek Romina Schwarzlin 《The Physician and sportsmedicine》2013,41(3):287-299
Background: In recent years, biofeedback has become increasingly popular for its proven success in peak performance training – the psychophysiological preparation of athletes for high-stakes sport competitions, such as the Olympic games. The aim of this research was to test whether an 8-week period of exposure to biofeedback training could improve the psychophysiological control over competitive anxiety and enhance athletic performance in participating subjects. Methods: Participants of this study were highly competent athletes, each training in different sport disciplines. The experimental group consisted of 18 athletes (4 women, 14 men), whereas the Control group had 21 athletes (4 women, 17 men). All athletes were between 16 and 34 years old. The biofeedback device, Nexus 10, was used to detect and measure the psychophysiological responses of athletes. Athletes from both groups (control and experimental) were subjected to stress tests at the beginning of the study and once again at its conclusion. In between, the experimental group received training in biofeedback techniques. We then calculated the overall percentage of athletes in the experimental group compared with those in the control group who were able to control respiration, skin conductance, heart rate, blood flow amplitude, heart rate variability, and heart respiration coherence. One year following completion of the initial study, we questioned athletes from the experimental group, to determine whether they continued to use these skills and if they could detect any subsequent enhancement in their athletic performance. Results: We demonstrated that a greater number of participants in the experimental group were able to successfully control their psychophysiological parameters, in comparison to their peers in the control group. Significant results (p < 0.05) were noted in regulation of GSR following short stress test conditions (p = 0.037), in regulation of HR after exposure to STROOP stressor (p = 0.037), in regulation of GSR following the Math and GSR stressors (p = 0.033, p = 0.409) and in achieving HR – breathing coherence following the math stressor (p = 0.042). Conclusion: One year following completion of the training program, all participants from the experimental group indicated that they were still using the biofeedback – psycho-regulation skills. Furthermore, these participants uniformly reported believing that these skills had enhanced their athletic performance and general well-being. 相似文献
15.
Objective. Spring ligament insufficiency is associated with chronic posterior tibial tendon dysfunction, and may constitute an indication
for surgical repair or reconstruction. This study examines the accuracy of MRI for the diagnosis of insufficiency of the spring
ligament. Design and patients. Two experienced musculoskeletal radiologists independently scored the MRI findings in 13 cases of surgically proven spring
ligament insufficiency and in 18 control subjects, using a standardized scoring system. Results. Insufficiency of the spring ligament was associated with increased signal heterogeneity on short TE spin echo images, and
an increase in the thickness of the medial portion of the ligament. The sensitivity of MRI for the diagnosis of spring ligament
insufficiency was 54–77%, while the specificity was 100%. MRI assessment of the plantar portion of the spring ligament was
unreliable (kappa=0.33), but the assessment of global ligament integrity was substantially reproducible (kappa=0.76). Conclusion. The medial portion of the spring ligament can be reliably assessed on routine MRI. The findings of spring ligament insufficiency
on MRI are only moderately sensitive but highly specific.
Received: 12 August 1998 Revision requested: 8 October 1998 Revision received: 21 January 1999 Accepted: 26 January 1999 相似文献
16.
Indirect wrist MR arthrography: the effects of passive motion versus active exercise 总被引:2,自引:0,他引:2
Purpose.In the wrist, to determine whether passive motion or active exercise yields a better indirect MR arthrographic effect following
intravenous gadolinium administration.
Design and patients. Twenty-six consecutive patients were studied by indirect wrist MR arthrography. In half active exercise and in half passive
motion was performed. Four regions of interest were studied including the distal radioulnar joint, the radiocarpal joint,
the midcarpal joint, and the triangular fibrocartilage. Ranges and means of signal intensity were calculated. Surgical follow-up
was performed in 22 patients.
Results. The joint fluid intensity was greatest in the distal radioulnar joint. Fluid signal intensity was greater and more consistent
in the passive motion group although the results did not achieve statistical significance. Imaging accuracy appeared similar
in the two groups and was excellent for the triangular fibrocartilage (100%) and scapholunate ligaments (96%).
Conclusion. Active exercise and passive motion yield similar degrees of wrist arthrographic effect, but the effect of passive motion
is somewhat more consistent. Preliminary data show good accuracy for internal derangements.
Received: 4 June 1999 Revision requested: 6 August 1999 Revision received: 14 September 1999 Accepted: 20 September 1999 相似文献
17.
Objective. To differentiate the MR features of septic versus nonseptic inflamed joints.
Design and patients. Thirty patients were referred for MRI with inflamed joints (19 were subsequently found to be septic and 11 nonseptic). At
1.5 T enhanced MRI five groups of signs related to joint space, synovium, cartilage, bone and peri-articular soft tissue respectively
were assessed and compared between the septic and nonseptic groups.
Results. The prevalence of MRI findings in septic versus nonseptic joints (respectively) was as follows: effusion (79% vs 82%), fluid
outpouching (79% vs 73%), fluid heterogeneity (21% vs 27%), synovial thickening (68% vs 55%), synovial periedema (63% vs 55%),
synovial enhancement (94% vs 88%), cartilage loss (53% vs 30%), bone erosions (79% vs 38%), bone erosions enhancement (77%
vs 43%), bone marrow edema (74% vs 38%), bone marrow enhancement (67% vs 50%), soft tissue edema (63% vs 78%), soft tissue
enhancement (67% vs 71%), periosteal edema (11% vs. 10%). The presence of bone erosions appeared to be an indicator for an
infected joint (P=0.072); coexistence of bone marrow edema slightly improves the significance (0.068). A similar trend was obtained when combining
bone erosions with either synovial thickening, synovial periedema, bone marrow enhancement or soft tissue edema (P=0.075).
Conclusions. The combination of bone erosions with marrow edema is highly suggestive for a septic articulation; the additional coexistence
of synovial thickening, synovial edema, soft tissue edema or bone marrow enhancement increases the above level of confidence.
Similar to conventional radiography, the single sign that appeared to show a significant trend was the presence of bone erosions.
However, no single sign or combination could either be considered pathognomonic or exclude the presence of a joint infection.
Received: 18 February 1999 Revision requested: 6 April 1999 Revision received: 26 July 1999 Accepted: 26 July 1999 相似文献
18.
McNally EG 《Skeletal radiology》1999,28(12):691-695
Objective. To define the imaging appearances in three cases of posteromedial subtalar coalition.
Design. Three patients who presented with hindfoot pain were found to have non-osseous coalition involving the posteromedial hindfoot.
This entity is distinct from conventional middle facet coalition as the sustentaculum is uninvolved.
Results. Plain radiographs, available in two cases, demonstrated subtle irregularity of the posterior facet. MRI (three cases) demonstrated
a mixed bony and cartilaginous mass lying posterior to the sustentaculum. There was trabecular oedema within the mass and
adjacent talus, and narrowing of the space between the middle and posterior facets. Prominence and dilatation of the posterior
tibial veins with tenosynovitis of the adjacent tibialis posterior tendon was seen. CT demonstrated the bony mass but did
not detect the adjacent bony oedema.
Conclusion. Posteromedial subtalar coalition may present with hindfoot pain and stiffness. The presence of a pseudarthrosis posterior
to a normal middle facet is characteristic. The abnormality can be difficult to detect on plain radiographs.
Received: 2 June 1999 Revision requested: 6 August 1999 Revision received: 13 September 1999 Accepted: 21 September 1999 相似文献
19.
MR findings of necrotic lesions and the extralesional area of osteonecrosis of the femoral head 总被引:4,自引:0,他引:4
Objective. To investigate the MR findings of necrotic lesions and the extralesional area of osteonecrosis of the femoral head (ONFH)
for each of the radiological stages.
Design and patients. Forty-nine hips in 29 patients (15 female, 14 male; mean age 38 years, range 17–59 years) were imaged using a 1.0-T superconducting
magnet. T2-weighted spin echo pulse sequences (T2WI), spoiled gradient recalled echo pulse sequences (SPGR) and fat suppression
SPGR (FS-SPGR), followed by Gd-DTPA enhanced fat suppression SPGR (Gd-FS-SPGR), were all obtained with the aid of a TORSO
surface coil.
Results and conclusions. While a normal fat intensity area with a low-intensity band on SPGR (band pattern) was seen in 16 of 16 stage 1 (100%), nine
of 11 stage 2 (82%), four of 17 stage 3 (24%), and none of five stage 4 hips, all hips showed peripheral rim enhancement on
Gd-FS-SPGR (100%). This enhancement band on Gd-FS-SPGR corresponded to histological findings of necrotic trabecular bone,
repaired marrow, and fibrous reparative tissue. Bone marrow edema was also clearly demonstrated as a diffuse, high-intensity
area outside this enhancement band on Gd-FS-SPGR in two stage 2 (18%), 12 stage 3 (71%), and one stage 4 hip (20%). In cases
at stage 2 or more advanced stages with homogeneous or inhomogeneous low intensity on nonenhanced MRI, the reparative process
both inside and outside the necrotic lesion, including bone marrow edema, was detected clearly on contrast- enhanced MRI.
Received: 3 August 1999 Revision requested: 28 September 1999 Revision received: 11 November 1999 Accepted: 2 December 1999 相似文献
20.
S. Iwasada Yukiharu Hasegawa Tosiki Iwase Shinji Kitamura Hisashi Iwata 《Skeletal radiology》1999,28(5):251-259
Objective. To assess the ability of bone scintigraphy and magnetic resonance imaging (MRI) to predict the outcome of transtrochanteric
rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). Design. This study was a prospective evaluation of imaging techniques. Patients and methods. MRI and bone scintigraphy were performed on 20 hips in 18 patients at 3 months after TRO. The radiographic findings at 3
months after TRO, and the MRI and bone scintigraphic findings, were compared with the radiographic findings at final follow-up
(mean 39 months). Results and conclusions. On MRI a low-intensity area or a low-intensity band in the new weight-bearing area extending over the acetabular edge on
T1-weighted images was related to the presence of collapse on the radiographs at final follow-up. In hips with an area of
absent activity in the new weight-bearing surface on bone scintigraphy, collapse was seen more frequently on radiographs at
final follow-up than in hips without this feature. Bone scintigraphy was no more specific than radiography in predicting the
outcome after TRO. We consider MRI to be superior to bone scintigraphy in predicting the occurrence of collapse, which is
one of the major short-term problems after TRO.
Received: 22 July 1997 Revision requested: 2 January 1998, 12 October 1998 Revision received: 3 March 1998, 23 December 1998
Accepted: 18 January 1999 相似文献