胫骨平台骨折的MRI诊断与评价

目的:探讨MRI在胫骨平台骨折中的临床应用价值。方法:66例胫骨平台骨折病例经X线检查后作MRI扫描,MRI扫描序列包括SE序列T1WI、FSE序列T2WI及STIR序列,每例骨折按Schatzker分类法分类,比较胫骨平台骨折的平片与MRI诊断结果,分析骨折合并膝关节其他损伤的MRI表现。结果:66例胫骨平台骨折病例中X线检查60例阳性(81.8%)。MRI检查65例阳性(98.5%),I型7例(10.6%)、II型20例(30.3%)、III型6例(9.1%)、IV型18例(27.3%)、V型4例(6.1%)、VI型10例(15.2%)。其中合并半月板损伤57例、韧带损伤48例、关节软骨损伤58例、局部骨挫伤34例、关节囊积液或积血61例。结论:MRI检查是术前评价胫骨平台骨折的一种实用和有效的方法。

Diagnosis and evaluation of tibial plateau fractures with MRI

Objective: To discuss the clinical value of MRI in tibial plateau fractures. Methods: Sixty-six patients of tibial plateau fractures associated with knee joint injuries were examined with MRI after X-ray plain film examination. Spin echo(SE) T1WI, fast spin echo(FSE) T2WI and short T1 inversion recovery(STIR) were acquired in knee joint of all patients. Each fracture was categorized according to the Schatzker classification. X-ray plain films were compared with MRI in diagnosing tibial plateau fractures. MRI appearances of injuried lesions of knee joints associated with fractures were assessed. Results: Sixty-six patients of tibial plateau fractures who had been diagnosed by X-ray film and 60 were found to have occult fracture. All of the 65 cases were found to have occult fracture by MRI. In our series, 7 cases(10.6%) of fractures were type I, 20 cases(30.3%) were type II, 6 cases(9.1%) were type III, 18 cases(27.3%) were type IV, 4 cases(6.1%) were type V, 10 cases(15.2%) were type VI. Within the 66 cases, it was found that in 57 cases there were meniscal injuries, 48 cases with ligamentous injuries, 58 cases with soft-tissue injuries, 34 cases with bone contusion, 61 cases with intra-articular effusion. Conclusion: MRI examination is a useful and comprehensive methods for evaluating tibial plateau fractures preoperatively.