创伤性关节积脂血征的CT及MRI诊断

目的 分析创伤性关节积脂血征的CT及MRI表现特点，探讨CT及MR／对创伤性关节积脂血征的诊断价值。方法 回顾性分析50例创伤性关节积脂血征患者的CT及MRI的影像学特征。其中膝关节36例、髋关节8例、肘关节4例及肩关节2例。所有患者均于受伤后1h至4d内行CT及MRI检查。结果 50例创伤性关节积脂血征患者均存在关节内骨折，创伤性关节积脂血征的CT及MRI表现为在关节囊内特征性的单液-液平面或双液-液平面积液征象。其中22例表现为单液-液平面积液征象，28例表现为双液-液平面积液征象。构成单液-液平面上、下2层液体和双液-液平面的上、中、下3层液体有明显不同的CT值和所有扫描序列中MRI信号强度。结论 创伤性关节积脂血征的CT及MRI检查均有特征性表现，CT及MRI检查可明确诊断创伤性关节积脂血征，创伤性关节积脂血征与关节内骨折并存，可以作为关节内骨折的可靠的间接征象。

Diagnosis of traumatic lipohemarthrosis by CT and MRI

Objective To evaluate the characteristics of CT and MRI manifestations of traumatic lipohemarthrosis.Methods The CT and MRI characteristics of 50 cases(36 knees,8 hips,4 elbows and(2 shoulders)) with traumatic lipohemarthrosis were studied retrospectively.CT and MRI scanning of all cases were performed between 1 hour and 4 days after trauma.Results Intra-articular fractures were showed on CT and MRI in all fifty cases with traumatic lipohemarthrosis.CT and MRI characteristics of traumatic lipohemarthrosis were single fluid-fluid levels or double fluid-fluid levels in the joint capsule.Twenty-two cases were single fluid-fluid levels,28 cases were double fluid-fluid levels in the joint capsule in this group.CT attenuations and MR signal intensity on all scan sequences of the superior band and the inferior band of single fluid-fluid levels or the superior band,the central band and the inferior band of double fluid-fluid levels were different.Conclusion Traumatic lipohemarthrosis has typical CT and MRI appearance.Traumatic lipohemarthrosis alert to the coexistence of an intra-articular fracture and is a clinically useful sign in detecting intra-articular fracture.