有诱因性和无诱因性骨梗死X线和磁共振成像表现的探讨

目的 探讨有无诱因性骨梗死的X线和磁共振成像(MRI)表现.方法 回顾性分析经临床MRI随访或手术病理证实的16例骨梗死患者的临床X线和MRI资料,分析其表现.所有患者均同期行X线片和MRI检查,二者检查间隔时间＜7 d.结果 6例骨梗死累及24个骨骼,包括肱骨2个、股骨14个和胫骨8个.临床上有大量激素应用史9例25灶,在MRI上T1WI和T2WI均表现为环状低信号带围绕的不同信号坏死区,相应X线片上19灶表现正常,6灶表现为地图状或环状骨质硬化.无明显诱因性骨梗死7例7灶,在MRI上T1WI呈不均匀低或等信号,T2WI呈低高混杂信号,周围绕环状低信号带,相应X线片上表现为局限性环状或地图状骨质硬化区.结论 有无诱因性骨梗死患者就诊时因所处的骨坏死时期不同,相应X线片和MRI表现也有所不同.

X-ray and MRI study of the bone infarction with or without etiology

Objective To study radiographic and MRI manifestation of the bone infarction with or without etiology. Methods A retrospective analysis of clinical X-ray and MRI data in 16 cases of bone infarction confirmed by clinical MRI follow-up or pathology were performed all patients underwent concomitant X-ray and MRI with intervals between two examinations less than 7 days. Results Sixteen cases of bone infarction involved the 24 bones, including two humerus, 14 femurs and 8 tibias. There were 25 lesions in 9 cases with a large number of hormone application history, which showed a circular low signal with different signal around the necrotic area on MRI T~WI and T2WI. Correspondingly, X-ray appeared normal in 19 lesions, and map-like or ring sclerotic in other 6 lesions. There were 7 cases of bone infarction without obvious etiology, which were uneven low or intermediate signal on T1WI, and low-high mixed signal surrounded with the ring low signal on T2WI, with the corresponding X-ray performance of ring or map-like osteosclerotic area. Conclusion The X-ray and MRI findings are somewhat different because the patients are in different periods of bone infarction with or without etiology while see- ing doctor.