骨梗死的临床与MRI探讨

目的：探讨非潜水性骨梗死的MRI表现。方法：6例非潜水性骨梗死共累及18个骨骼，其中15个受累骨经手术病理证实。所有病例均行MR T1WI，T2WI，质子密度加权像（PDWI）。梯度回波快速小角度激发序列（FLASH）淮T2WI及X线平片检查。结果：（1）主要MRI征象，病灶中心T1WI呈等骨髓信号，T2WI呈等，高混杂信号。病灶边缘T1WI呈花边状低信号带，T2WI呈内高外低2层。（2）病灶较小（＜2cm)或（和）出现硬化时MRI表现不典型，见于9个典型病灶周围骨髓内和1个距骨。（3）11个病骨累及邻近关节并出现关节症状（11／18）。（4）X线平片对本病诊断价值有限（本组阳性诊断9／18，正确诊断3／18）。结论：MRI是本病最好的检查手段，能完全明确本病的诊断和侵及范围。

Clinical and MRI study of the bone infarction

Objective To study MRI manifestation of the non-diver bone infarction. Methods Six cases of non-diver bone infarction involved 18 bones totally, in which 15 bones were confirmed by surgical operation and pathology. All cases were examined by MRI through T 1WI, T 2WI, PDWI, FLASH T 2WI, and by X-ray plain film. Result (1) Major MRI manifestation was moderate signal intensity on T 1WI and inhomogenous high signal intensity on T 2WI in the centers of the foci whose margin were rugged and rough bands which were low signal intensity on T 1WI and two layers on T 2WI. (2) MRI manifestation was atypical when focus was small (<2 cm) or (and)became sclerosed. (3) 11 ill-bones involved adjacent joints and the symptom of joints appeared. (4) The diagnostic value of X-ray plain film was limited (the positive ratio was 9/18 and its definite diagnosis ratio was only 3/18). Conclusion MRI is the best way to examine and detect bone infarction. It can make a definite diagnosis of bone infarction and delineate the range of involvedment.