MRI在膝关节隐匿性骨折诊断中的应用

目的分析磁共振成像(MRI)在膝关节隐匿性骨折诊断中的应用价值。方法选取2019年5月至2020年7月我院收治的X线检查阴性且怀疑膝关节骨折患者61例,均行多层螺旋CT(MSCT)及MRI检查,分析其影像学特点,比较两种检查方法对骨折检出情况及对骨折塌陷程度、水平错位程度显示率,并分析诊断效能。结果MRI下,膝关节隐匿性骨折表现为T1WI呈片状不均匀低或略低信号,骨折线周围有模糊片状高信号,皮质下或松质骨内有条状信号影/不规则线,T2WI可发现骨折线或在骨折线周围有散点片状高或略高信号,MSCT可见骨质连续性中断或伴骨折线,移位骨折和局部骨折缺损吻合;MRI对膝关节隐匿性骨折中半月板损伤、少量关节腔积液及韧带损伤检出率较MSCT高(P<0.05),对严重骨折的检出率无差异(P>0.05);MRI对膝关节隐匿性骨折塌陷程度、水平错位程度的显示率均高于MSCT(P<0.05);MRI诊断膝关节隐匿性骨折的敏感度、准确度高于MSCT(P<0.05),而特异度比较差异无统计学意义(P>0.05)。结论MRI在膝关节隐匿性骨折中有一定诊断价值,可提高对病变及骨折塌陷程度、水平错位程度的显示率,整体诊断效能较MSCT高,值得在临床推广实践。

Application of MRI in the Diagnosis of Occult Knee Fractures

Objective To analyze the application value of magnetic resonance imaging(MRI)in the diagnosis of occult knee fractures.Methods Sixty-one patients with negative X-ray examination results and suspected knee fractures admitted to the hospital from May 2019 to July 2020 were enrolled.All underwent multi-slice spiral CT(MSCT)and MRI examinations to analyze their imaging cha racteristics.Thedetection situations of fractu res,and display rates of fractu re colla pse and horizontal dislocation by the two methods were compa red.And their diagnostic efficiency was analyzed.Results Under MRI,occult knee fractures showed flake-like,uneven and low or slightly low signals on T1 WI,there were fuzzy and flake-like high signals around fracture lines,there were striped signal shadows/irregular lines under the cortex or in cancellous bone.On T2 WI,there were scattered and flake-likehigh or slightly high signals in fracture lines or around the fracture lines.MSCT showed that there was bone continuity interru ption or fra ctu re line,anastomosis of displa ced fractu re and local fracture defects.The detection rates of meniscus injury,little joint effusion and ligament injury by MRI were higher than those by MSCT(P<0.05),while there was no significa nt difference in the detection rate of severe fractures between the two methods(P>0.05).The display rates of fracture collapse and horizontal dislocation byMRI were higher than those by MSCT(P<0.05).The sensitivity and accuracy of MRI in the diagnosis of occult knee fractures were higher than those of MSCT(P<0.05),but there was no significant difference in specificity between the two methods(P>0.05).Conclusion MRI is of certain diagnostic value in occult knee fractures,which can increase the display rates of lesions,fracture colla pse and horizontal dislocation.The ove rall diagnostic efficiency is higher than that of MSCT.