潜水减压病性骨梗死的影像学表现

目的探讨潜水减压病性骨梗死的影像学表现。方法 19例患者23个部位均行X线、CT、MR检查,病变累及股骨颈、股骨粗隆、肱骨上端、胫骨下端。结果骨梗死早、中期X线片、CT表现为阴性和局部骨质疏松及斑点状钙化;MRI表现为中央T1WI为中等或略低信号,边缘为迂曲清楚的线状低信号带,T2WI为中央等略高而边缘高信号带,边缘呈典型的地图样改变,反映了骨梗死内的反应性新骨形成、纤维化、出血和骨髓水肿。晚期X线及CT呈不规则状骨质硬化,MRI T1WI及T2WI示梗死区中央及边缘均为低信号,这意味坏死组织被肉芽组织和纤维组织替代,及营养不良性钙化和骨化。结论 MRI是诊断早期骨梗死的最有效的方法,而中晚期骨梗死在X线平片、CT及MRI上均有特征性表现,三者结合可以提高诊断率。

Imaging finding on bone infarction induced by DSC and its pathological foundation

Objective To explore the diagnostic points of bone infarction inducel by DSC(decompression) and it's pathological foundation.Methods Radiography,CT and MR were performed in 19 patients with 23 bone infarction.Lesions occurred on the upper part of femur and the upper and low part of tibia.Results At the early and middle stages,osteoporsis and punctuate calcification could be seen on plain film and CT scans.The center of infarction manifested as iso-or slight low signal on T1WI and iso-or slight high-signal on T2WI;the surrounding part was map-shaped lesion,which were reflecting reactive bone formation,fibrosis and congestive edema.At the later stages the lesions were characterized by irregular sclerosis and tortuons calcification on X-ray and CT,and by low-signal on T1WI and T2WI,which were indicating the formation of fibrosis and dystrophic calcification due to the replacement of necrotic tissue by granulation and fibroustissue.Conclusion MRI is the most effective way to find the bone infarction at the early and the middle stages.At later stage the lesion shows certain charateristic signs on plain film CT or MRI,X-ray,CT and MRI should be combined each other in diagnosing bone infaraction,so as to enhance diagnostic rate.