共查询到20条相似文献,搜索用时 15 毫秒
1.
D. Thickman M.D. L. Axel M.D. H. Y. Kressel M.D. M. Steinberg M.D. H. Chen M.D. M. Velchick M.D. M. Fallon M.D. M. Dalinka M.D. 《Skeletal radiology》1986,15(2):133-140
This study investigates the role of magnetic resonance imaging (MR) in identifying avascular necrosis (AVN) of the femoral head and in monitoring its therapy. The detection of AVN, particularly in its early stages, is imperative to give therapeutic intervention the best opportunity for successful management. The results of magnetic resonance imaging are compared with those of the standard diagnostic modalities in evaluation of patients with the lesion. Examinations were performed at 0.12 T with a repetition time (TR) of 143 ms and times to echo (TE's) of 10 or 20 ms. This study represents a retrospective review of 90 hips which were examined in 45 consecutive patients. Of these, 52 hips were biopsied as part of treatment. MR was shown to be sensitive in the detection of AVN. Comparison of MR with radionuclide imaging showed comparable sensitivity and specificity. MR was also noted to be sensitive in the detection of early AVN. Preliminary results suggest that MR can monitor treatment of the affected hip, and may even be able to predict patient response to therapy. Although further work is necessary to determine the role of MR in the evaluation of the patient presenting with hip pain, MR is a sensitive method in detecting AVN and in monitoring its course in patients suspected of having the disease. 相似文献
2.
This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral
insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral
collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band
on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized
by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line.
There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple
occurrence of collapsed subchondral insufficiency fracture.
Received: 22 May 1999 Revision requested: 5 August 1999 Revision received: 13 September 1999 Accepted: 15 September 1999 相似文献
3.
Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI 总被引:5,自引:0,他引:5
Objective. To correlate the magnetic resonance imaging (MRI) features with the histopathologic findings in subchondral insufficiency
fracture (SIF) of the femoral head.
Design and patients. This study was based on a retrospective review of the MRI features and histopathologic findings in seven patients with SIF
who had had total hip replacement.
Results. In all seven cases, MRI showed a bone marrow edema pattern in the femoral head, and a focal low-intensity band beneath the
articular cartilage on some slices (not all) on the T1-weighted images. The shape of the low-intensity band varied: it was
irregular and serpentine in four cases, well-delineated, smooth, and a mirror image to the articular surface in two cases,
and parallel to the articular surface in one case. On histologic examination, the low-intensity band on MRI corresponded to
a fracture line and its associated repair tissue. In all but one case, the band was not visible on T2-weighted or fat suppression
images, and the proximal subchondral portion of the lesion had a homogeneous high signal intensity. This region of high signal
intensity corresponded histopathologically to viable bone and marrow tissue with associated callus, edema, and vascular granulation
tissue.
Conclusions. SIF of the femoral head characteristically demonstrates a low-intensity band on T1-weighted images that corresponds, histopathologically,
to a linear subchondral fracture and its associated repair tissue. In most cases, the subchondral portion of the lesion appears
on T2-weighted images as an area of homogeneously high signal intensity.
Received: 1 June 2000 Revision requested: 17 August 2000 Revision received: 11 October 2000 Accepted: 9 January 2001 相似文献
4.
Rapid destructive arthritis of the shoulder 总被引:1,自引:0,他引:1
V. D. Nguyen 《Skeletal radiology》1996,25(2):107-112
Rapid destructive arthritis of the shoulder, although uncommon, has received much attention in the recent medical literature.
It has been described by several authors under varied names: hemorrhagic shoulder of the elderly, Milwaukee shoulder syndrome,
rapid destructive arthritis of the shoulder, apatite-associated destructive arthritis and idiopathic destructive arthritis
of the shoulder. This particular form of arthritis affects mainly elderly patients, predominantly women, with limited pain,
rotator cuff tear, joint instability, voluminous mildly inflammatory, blood-stained effusion, basic calcium phosphate crystals,
and marked joint and bone destruction. 相似文献
5.
Jean Leone Jean-Pierre Vilque Bernard Pignon Claude Marcus Jean-Loup Pennaforte Jean-Paul Eschard Jean-Claude Etienne 《Skeletal radiology》1996,25(7):696-698
A 17-year-old male patient complaining of intense pain in his right hip was found to be suffering from chronic myelogenous
leukaemia. Preliminary X-rays and bone scintigraphy did not suggest avascular necrosis of the femoral head. Magnetic resonance
imaging (MRI) did, however, reveal leukaemic infiltration of the femoral neck and generalised ischeamia in the femoral head.
Further, MRI carried out 4 months later disclosed typical signs of osteonecrosis, despite previous indications of an improvement
under chemotherapy. Flattening of the head of the femur appeared in radiographs taken in the 9th month. In the 12th month,
recurrence of pain made it necessary to perform a total hip arthroplasty. Anatomo-pathological investigation confirmed both
the necrosis and the leukaemic invasion. 相似文献
6.
Malizos KN Karantanas AH Varitimidis SE Dailiana ZH Bargiotas K Maris T 《European journal of radiology》2007,63(1):16-28
Osteonecrosis of the femoral head is a disabling clinical entity affecting young adults that usually leads to destruction of the hip joint. A high index of suspicion is necessary for the diagnosis due to the insidious onset of the bone infarcts and the lack of specific clinical signs at the early stages. Many etiology-associated factors have been identified reducing thus the number of idiopathic cases. A number of joint salvaging treatment options are available if early diagnosis can be achieved. MR imaging has been proved to be a highly accurate method both for early diagnosis and for staging of the disease. Replacement of the hip joint is the last resort for pain relief and function, although non-desirable because of the young age of the affected population. 相似文献
7.
Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after
ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee
MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee
examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging
was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR
results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears,
with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent
site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries
of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella
in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture.
MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination
of the knee. 相似文献
8.
Terence C. F. Tan Dennis M. Wilcox Lawrence Frank Chunhsi Shih Deborah J. Trudell David J. Sartoris D. Resnick 《Skeletal radiology》1996,25(8):749-755
Objective. To assess hyaline cartilage of cadaveric ankles using different magnetic resonance (MR) imaging techniques and various methods
of measurement. Design and patients. Cartilage thicknesses of the talus and tibia were measured in ten cadaveric ankles by naked eye and by digitized image analysis
from MR images of fat-suppressed T1-weighted gradient recalled (FS-SPGR), sequences and pulsed transfer saturation sequences
with (FS-STS) and without fat-suppression (STS); these measurements were compared with those derived from direct inspection
of cadaveric sections. The accuracy and precision errors were evaluated statistically for each imaging technique as well as
measuring method. Contrast-to-noise ratios of cartilage versus joint fluid and marrow were compared for each of the imaging
sequences. Results. Statistically, measurements from FS-SPGR images were associated with the smallest estimation error. Precision error of measurements
derived from digitized image analysis was found to be smaller than that derived from naked eye measurements. Cartilage thickness
measurements in images from STS and FS-STS sequences revealed larger errors in both accuracy and precision. Interobserver
variance was larger in naked eye assessment of the cartilage. Contrast-to-noise ratio of cartilage versus joint fluid and
marrow was higher with FS-SPGR than with FS-STS or STS sequences. Conclusion. Of the sequences and measurement techniques studied, the FS-SPGR sequence combined with the use of digitized image analysis
provides the most accurate method for the assessment of ankle hyaline cartilage. 相似文献
9.
A clinicopathologic study of transient osteoporosis of the hip 总被引:5,自引:0,他引:5
Objective. It has been proposed that transient osteoporosis of the hip (TOH) may represent the early reversible phase of osteonecrosis
of the femoral head (ON). The purpose of this study was to investigate the clinicopathologic characteristics of three cases
of TOH.
Design and patients. A bone biopsy was performed on three patients who had been diagnosed as having TOH based on the clinical course, radiograph,
bone scintigram, and MR images. The biopsy specimens were studied histopathologically by light and electron microscopy.
Results. The most characteristic feature of TOH was focal areas of thin and disconnected bone trabeculae covered by osteoid seams
and active osteoblasts. The surrounding bone marrow tissue showed edematous changes and mild fibrosis, frequently associated
with vascular congestion and/or interstitial hemorrhage. No osteonecrotic region was observed in either the bone trabeculae
or the bone marrow tissue. All patients have improved clinically and in the 3.5–9 years of follow-up have shown no evidence
of ON.
Conclusions. This study supports the concept that transient osteoporosis of the hip is a distinct entity.
Received: 25 January 1999 Revision requested: 16 April 1999 Revision received: 30 July 1999 Accepted: 12 August 1999 相似文献
10.
MR imaging of the Achilles tendon: overlap of findings in symptomatic and asymptomatic individuals 总被引:3,自引:0,他引:3
Objective: To differentiate MR imaging characteristics of symptomatic as compared with asymptomatic Achilles tendons.
Design: 1.5 T MR images of 94 feet (88 patients) with ”abnormal” MR examinations were retrospectively evaluated and clinically correlated.
Two masked, independent observers systematically evaluated for intratendon T2 signal, tendon thickness, presence of peritendonitis,
retrocalcaneal bursal fluid volume, pre-Achilles edema, bone marrow edema at the Achilles insertion, and tears (interstitial,
partial, complete). These findings were correlated with symptoms (onset and duration) and physical examination results (tenderness,
palpable defects, increased angle of resting dorsiflexion).
Results: Of the 94 ankles, 64 ankles (32 females, 29 males) were clinically symptomatic. No relationship between Achilles tendon
disorders and age or gender was identified. Asymptomatic Achilles tendons frequently demonstrated mild increased intratendon
signal (21/30), 0.747 cm average tendon thickness, peritendonitis (11/30), pre-Achilles edema (12/30), and 0.104 ml average
retrocalcaneal bursal fluid volume. Symptomatic patients had thicker tendons (0.877 cm), greater retrocalcaneal fluid volume
(0.278 ml), more frequent tears (23/64), a similar frequency of peritendonitis (22/64) but less frequent pre-Achilles edema
(18/64). Sixty-four percent of the Achilles tendon tears were interstitial. Except for two interstitial tears in control patients,
the majority of Achilles tears were in symptomatic patients (14/16). Only symptomatic tendons demonstrated partial or complete
tendon tears. In addition, calcaneal edema was found almost exclusively in actively symptomatic patients. Thicker tendons
were associated more often with chronic symptoms and with tears. When present in symptomatic patients, peritendonitis was
usually associated with acute symptoms. The presence of pre-Achilles edema, however, did not distinguish acute from chronic
disorders.
Conclusion: There is significant overlap of MR findings in symptomatic and asymptomatic Achilles tendons. Furthermore, there is apparently
a spectrum of disease in symptomatic tendons ranging from subtle intratendinous and peritendinous signal to partial and complete
tendon tear.
Received: 17 March 2000 Revision requested: 26 May 2000 Revision received: 19 July 2000 Accepted: 19 July 2000 相似文献
11.
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
12.
Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings 总被引:5,自引:0,他引:5
Objective. We investigated the usefulness of plain film and MR findings in predicting the outcome of conservatively treated patients
with femoral osteochondritis dissecans. Design. Without knowledge of the clinical outcome, we retrospectively reviewed the initial plain films and MR examinations. Each MR
examination was evaluated for the four MR findings of instability. Patients. Fourteen patients were studied in whom osteochondritis dissecans of a femoral condyle had been treated conservatively for
periods ranging from 1.2 to 8.5 years. Results and conclusion. Three of five patients with an open femoral growth plate and one of nine patients with a closed growth plate had a good clinical
outcome. Both patients with lesions smaller than 160 mm2 in area had a good outcome and ten of 12 patients with larger lesions had a poor outcome. Both patients with stable lesions
by MR imaging had a good outcome while ten of 12 patients with a lesion unstable by MR imaging had poor outcomes. All six
patients with a cartilage fracture or articular defect had poor outcomes. The results of this study should be considered preliminary
since only 14 patients were followed. However, it appears that a good clinical outcome is likely when the femoral growth plate
is open, when the osteochondritis dissecans is small, and when the lesion is stable by MR imaging. When a cartilage fracture
or articular defect is found on MR imaging, the patient is likely to have a poor outcome. 相似文献
13.
Williams M Laredo JD Setbon S Bélangé G Timsit MA Karneff A Pertuiset E 《Skeletal radiology》1999,28(2):81-85
We present five cases of a distinctive type of longitudinal stress fracture of the upper femoral shaft in which the fracture
line is parallel to the outer surface of the bone, in contrast to the perpendicular orientation to the cortical surface in
previously reported cases of diaphyseal stress fractures. In two cases the fracture recurred after 15 and 18 months, respectively.
Received: 25 May 1998; Revision requested: 27 July 1998; Revision received: 17 August 1998; Accepted: 8 September 1998 相似文献
14.
Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture 总被引:5,自引:0,他引:5
The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures
of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee,
we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee,
studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66–84 years) presented spontaneous
osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients
also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous
osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau
was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous
osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial
tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis
of knee. 相似文献
15.
Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR
imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about
the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and
position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm
in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment
of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful
for assessment of the median and radial nerves in the forearm. 相似文献
16.
Villeirs G Van Damme S Heydanus R Serreyn R Kunnen M Mortier M 《European radiology》2000,10(3):527-530
Fat necrosis of the breast is a well-known complication following trauma, surgery, or radiotherapy. The present paper describes
a rare case of fat necrosis after heparin-induced thrombocytopenia. The mammographic, sonographic, and MR evaluation and pathologic
correlation after a 1-year follow-up period are reported.
Received: 21 January 1999; Revision received: 3 June 1999; Accepted: 5 July 1999 相似文献
17.
Vande Berg BC Lecouvet FE Koutaissoff S Simoni P Malghem J 《European journal of radiology》2008,67(1):68-77
The current article of this issue aims at defining the generic term of bone marrow edema of the femoral head as seen at MR imaging. It must be kept in mind that this syndrome should be regarded, not as a specific diagnosis, but rather as a sign of an ongoing abnormal process that involves the femoral head and/or the hip joint. We aim at emphasizing the role of the radiologists in making a specific diagnosis, starting from a non-specific finding on T1-weighted images and by focusing on ancillary findings on T2-weighted SE or fat-saturated proton-density weighted MR images. 相似文献
18.
Summary
The concept of MR guidance of invasive diagnostic and minimally invasive therapeutic procedures is based on the excellent
morphologic and functional properties of MR imaging. Prerequisites are adequate patient monitoring and adherence to safety
guidelines. Fast and ultrafast sequences, temperature quantification, visualization of intravascular devices, thermal stability
of contrast media and thermosensitive contrast media are discussed. The spectrum of clinical applications includes biopsies,
thermal ablation modalities, vascular applications, MR endoscopy and intraoperative MR imaging. The development of interventional
MR imaging is still in its infancy. In the future, MR imaging may play an important role in interventional radiology and minimally
invasive therapy.
相似文献
19.
目的探讨股骨转子下骨折伴股骨头缺血性坏死经一次性全髋人工关节置换术的手术可行性和疗效。方法自1998年4月至2003年4月,对12例外伤性股骨转子下新鲜骨折伴股骨头缺血性坏死患者行一次性全髋人工关节置换术。其中男2例,女10例;年龄57~84岁,平均71.5岁。均伴有股骨头缺血性坏死。股骨头坏死按照Ficat分类,Ⅱ型3例,Ⅲ型5例,Ⅳ型4例。骨折类型按照AO分类均为A型长斜形股骨转子下骨折,按照Russell—Taylor分类均为IA型转子下骨折。均采用美国DePuy公司的Solution全涂层长柄股骨假体。结果1例发生术中再骨折,术后早期并发症有泌尿系统感染3例,深静脉栓塞4例。术后绝对卧床1个月。术后随访6~24个月,平均14.6个月。8例患者在术后4个月恢复步行能力,4例在1年后仍需扶拐步行。经美国特种外科医院(Hospital for Special Surgery,HSS)评分为84~92分,平均87分。结论伴股骨头缺血性坏死的老年患者发生股骨转子下骨折经一次性全髋人工关节置换术,虽然手术增加了一定的危险性,但可以减少二次手术的痛苦。 相似文献
20.
Magnetic resonance imaging in the assessment of urologic disease: an all-in-one approach 总被引:9,自引:0,他引:9
Verswijvel GA Oyen RH Van Poppel HP Goethuys H Maes B Vaninbrouckx J Bosmans H Marchal G 《European radiology》2000,10(10):1614-1619
The aim of this study was to evaluate an “all-in-one” MR procedure to examine the kidneys, the renal vascular supply and
renal perfusion, and the urinary tract. In 64 patients (58 with urologic disease and 6 healthy volunteers), MR was performed
including: (a) T1- and T2-weighted imaging; (b) 3D contrast-enhanced MR angiography (MRA), including the renal arteries, renal
veins, as well as renal perfusion; and (c) 3D contrast-enhanced MR urography (MRU) in the coronal and sagittal plane. For
the latter, low- and high-resolution images were compared. Prior to gadolinium injection, 0.1 mg/kg body weight of furosemide
was administered intravenously. The results were compared with correlative imaging modalities (ultrasonography, intravenous
urography, CT), ureterorenoscopy and/or surgical–pathologic findings. Visualization of the renal parenchyma, the vascular
supply, and the collecting system was adequate in all cases, both in nondilated and in dilated systems and irrespective of
the renal function. One infiltrating urothelial cancer was missed; there was one false-positive urothelial malignancy. Different
MR techniques can be combined to establish an all-in-one imaging modality in the assessment of diseases which affect the kidneys
and urinary tracts. Continuous refinement of the applied MR techniques and further improvements in spatial resolution is needed
to expand the actual imaging possibilities and to create new tracts and challenges in the MR evaluation of urologic disease.
Received: 27 September 1999; Revised: 20 January 2000; Accepted: 22 May 2000 相似文献