应力性骨折影像诊断

目的应力性骨折,由于缺乏正确认识常造成误诊,本文重点强调影像诊断的价值。方法回顾性总结了1977～2000年间的应力性骨折64例,男性27例,女性37例。64例均进行X线检查,28例不典型者随后行ECT、MRI、CT检查。结果将应力性骨折分为疲劳性和衰竭性应力骨折两大类,其中疲劳性应力骨折12例占18.7%,衰竭性应力骨折52例占81.3%。36例为单纯平片诊断,28例平片结合ECT、MRI、CT诊断。疲劳性应力骨折以青少年胫骨常见;衰竭性应力骨折以老年妇女的胸、腰椎为多发区域。结论应力性骨折通常根据临床和X线平片即可明确诊断,疑难病例或早期诊断应结合ECT、MRI和CT扫描作出诊断。

Imaging diagnosis of stress fracture

Objetive Stress fracture is often misdiagnosed because of some misunderstandings. Our study is to explore the value of imaging in diagnosing the stress fracture. Methods We analyzed 64 cases of stress fracture,of which 27 were male and 37 were female. Plain X ray examinations were performed for all of them, and the ECT, MRI, CT examinations followed in 28 cases. Results We divided the stress fracture into fatigue fracture and insufficiency fracture. In our study, 12 cases were of the fatigue fracture, 18.7%in all cases; and the other 52 cases were of the insufficiency fracture, 81.3%in all cases. 36 cases were diagnosed by the plain films only, and other 28 cases by a combination of ECT, MRI, CT imaging. The fatigue fracture was dominantly seen in the tibia of the adolescent, while the thoracic and lumber spines of old female were the common area of the insufficiency fracture. Conclusion Generally the stress fracture can be diagnosed according to the clinical appearance and X ray plain film. But the ECT, and MR imaging are also necessary in diagnosing difficult cases and the fracture at its early stage.