糖尿病足患者骰骨病变的MRI和X线特征

目的分析糖尿病足(DF)患者骰骨病变的MRI及X线表现。方法回顾性分析124例不同类型的足部病变患者的MRI、X线资料,其中DF组54例,非DF组70例,观察两组患者骰骨信号改变、单纯骨髓水肿、骨髓水肿合并骨折、骰骨与周围骨的关系的MRI、X线的差异。结果两组患者骰骨信号改变、单纯骨髓水肿、骨髓水肿合并骨折的差异均有统计学意义(P均0.05)。DF组中,18例(18/54,33.33%)表现为单纯骨髓水肿,T1WI呈等低信号,T2WI呈高信号,增强扫描无明显强化;非DF组中,8例(8/70,11.43%)单纯骨髓水肿。DF组中,6例(6/54,11.11%)表现为骨髓水肿合并骨折,骨折T1WI呈线样、模糊低信号影,骨皮质不连续,仅1例骰骨骨折X线平片可见;非DF组中,1例(1/70,1.43%)表现为骨髓水肿合并骨折,X线平片不可见。DF组,1例骰骨骨髓炎,3例骰骨周围关节腔积液,2例合并夏科关节病;非DF组1例可见关节腔积液。结论 DF患者较非DF患者骰骨更易受损,出现骨髓水肿和骨折,结合MR影像特征有利于对DF患者骰骨病变的诊断。

MRI and X-ray features of cuboid bone in diabetic foot patients

Objective To investigate the MRI and X-ray characteristics of cuboid bone in patients with diabetic foot (DF). Methods MRI and X-ray examinations of 124 patients with foot diseases were reviewed, including 54 cases in DF group, 70 cases in non-DF group. The signals of cuboid bone changes, simple marrow edema, marrow edema with fractures and the relationship between cuboid bone and the surrounding in both groups in MRI and X-ray were compared. Results There was statistical significance between groups in signals of cuboid bone changes, simple marrow edema, marrow edema with fractures and the relationship between cuboid bone and the surrounding (all P<0.05). In DF group, 18 patients (18/54, 33.33%) were with simple marrow edema performed as iso- or low signal intensity on T1WI, hyperintense on T2WI, and no significant enhancement were observed. In non-DF group, 8 patients (8/70, 11.43%) suffered from simple marrow edema. In DF group, 6 patients (6/54, 11.11%) suffered from marrow edema with fractures performed as thready and fuzzy low signal intensity on T1WI, only 1 patient was observed fractures in X-ray. In non-DF group, only 1 patient (1/70, 1.43%) suffered from marrow edema with fractures, no one was observed in X-ray. In DF group, 1 patient suffered form osteomyelitis in cuboid bone, 3 patients suffered form accumulating fluid in articulatory antrum around cuboid bone, 2 patients combined with Charcot''s arthropathy; only 1 patient suffered form accumulating fluid in articulatory antrum in non-DF group. Conclusion The cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients, combined with the MR imaging features is helpful to diagnose the cuboid bone changes in DF patients.