MRI在隐匿性骨折诊断中的临床价值

目的:探讨骨隐性骨折MRI诊断价值。材料与方法:我院2011年4月至2014年5月对临床高度怀疑隐性骨折而常规X线平片检查骨质未见明显异常患者124例进行MRI检查。结果:其中膝关节周围64例、脊柱36例、髋关节8例、胫骨中下段8例、踝关节周围6例、眼眶2例。MRI主要表现为在SE序列T1WI上均呈片状广泛或局限的不规则的低信号,在FSE序列或TSE序列T2WI上呈高信号或略高信号,其范围和程度不如T1WI所显示明显,在STIR序列上,均呈明显的片状高信号,隐性创伤性骨折尚能显示一条或多条线样异常信号,代表骨小梁断裂交错形成的骨折线,线样异常信号多呈低信号,亦可以表现为高低混杂的异常信号带,常伴有韧带、软骨等损伤。结论:X线平片虽为外伤性骨折的基本检查方法,但易漏诊,若患者局部症状明显,X线检查无阳性征象者应行MRI检查,MRI检查可提高隐匿性骨折检出率,尤其是MRI能早期诊断骨隐性骨折。

Clinical Value of MRI in the Diagnosis of Occult Fracture

Purpose： MRI diagnostic value for hidden fracture are discussed. Materials and Methods： From April 2011 to May 2014 to clinical recessive highly suspected fracture and conventional X-ray plain film check 124 patients with bone saw no obvious abnormalities on MRI. Results ： With 64 cases around the knee joint and 36 cases, 8 cases of the hip, spine tibial middle period of 8 cases, 6 cases around the ankle, eyes in 2 cases. Magnetic resonance imaging is mainly on the SE sequence T1 WI plate shaped widely or irregular low signal, in FSE sequence or TSE sequence has high signal on T2W1 or slightly high signal, its scope and degree than TT WI shows, on STIR sequence, all show obvious shape signal, high recessive traumatic fractures can display one or more abnormal signal line samples, on behalf of the trabecular bone fracture staggered formation of the fracture line, the abnormal signal in low signal line samples, also can be mixed with abnormal signal, often accompanied by ligaments, cartilage injury. Conclusion： X-ray plain film is basic inspection method for traumatic fractures, but fetal hydrops, if patients with local symptoms, X-ray hue no positive signs shall be MRI, MRI can improve the occult frac- ture detection, especially MRI can recessive early diagnosis of bone fracture.