创伤性关节脂血症的影像学特征及其诊断价值

目的：分析创伤性关节脂血症的影像学特征．探讨其对关节囊内骨折的诊断价值。方法：回顾性分析研究100例经手术或穿刺证实的创伤性关节脂血症患者行X线、CT及MRI检查并分析影像学资料。结果：100例患者经3种检查方法印证均存在关节内骨折。X线表现为关节囊肿胀，密度增高与肌肉近似，经特殊体位投照部分可显示脂液平征象。CT全部清晰显示关节囊内有脂液平征．其中单液-液平征72例，双液-液平征25例，气体脂肪血液单或双液-液平征3例。MRI有明确脂液平征89例，位于膝、髋等大关节。脂液平征不明确者11例，位于踝、腕等小而复杂的关节。构成关节囊内单液-液平征的上下2层液体和双液-液平征的上、中、下3层液体有明显不同的CT值和MRI信号强度，其中最上层CT为脂肪密度、MRI为脂肪信号。结论：CT示脂血症清晰而准确，对大部分囊内骨折能明确诊断。MRI对小关节脂血症的诊断不如CT，但对关节囊内骨折及其附属结构损伤的显示明显优于X线片及CT。创伤性关节脂血症可作为关节内骨折可靠的间接征象。

Imaging Characteristics of Traumatic Lipohemarthrosis

Objective:To investigate the manifestations of X-ray,CT and MR of the traumatic lipohemarthrosis and their diagnostic value.Methods:The X-ray,CT and MR characteristics of 100 cases with traumatic lipohemarthrosis proved by operation or puncturation were studied retrospectively.Results:Intra-articular fractures were shown on X-ray,CT or MR in all 100 cases with traumatic lipohemarthrosis.X-ray examination showed articular capsule swelling and increase of density similar to muscle,radiography in horizontal pr...