摘要
目的探讨婴儿长骨急性血源性骨髓炎的MRI表现及其诊断价值。资料与方法 21例长骨急性血源性骨髓炎病例均经临床及病理证实,9例采用Siemens Novus 0.35 T MR机,12例采用Siemens Avanto 1.5 T超导型MR机对病灶及邻近关节行轴位、矢状位及冠状位扫描。结果将婴儿长骨急性血源性骨髓炎分为三种类型:(1)骨骺干骺型(16例):病变位于股骨干骺端6例、胫骨干骺端5例、肱骨干骺端5例。16例长骨干骺端病灶合并骨骺及骺板受累、化脓性关节炎,其中2例合并骨膜下脓肿,1例合并骨骺分离,1例合并关节脱位,病灶在T1WI呈低或稍低信号,T2WI、PD-STIR及梯度回波序列呈高信号,以PD-STIR显示更明显;(2)干骺型(3例):病变位于股骨干骺端2例,胫骨干骺端1例,无骺板及骨骺受累,病灶呈片状稍长T1、长T2信号;(3)骨干型(2例):病变位于胫骨及尺桡骨骨干各1例,MRI表现为骨干广泛骨质破坏及骨膜反应。2例增强扫描髓腔内病灶及周围软组织见不均匀斑片状强化。结论婴儿长骨急性血源性骨髓炎有其自身发病特点,认识其病理解剖学基础及MRI表现,对评价骨髓炎的严重程度及预后有十分重要的意义。
Objective To discuss the MRI manifestations of acute haematogenous osteomyelitis of long bone and to evaluate its diagnostic value.Materials and Methods 21 consecutive patients with acute haematogenous osteomyelitis of long bone confirmed clinically and pathologically were collected.Nine of 21 patients were performed with 0.35 Tesla scanner and other 12 patients by 1.5 Tesla scanner.Axial,sagtial and coronal imagings were obtained.Results Acute haematogenous osteomyelitis of long bone in infants might be divided into three groups：（1）epiphysis and metaphysis（16 cases）：six lesions were located in the metaphysis of femur,5 in the metaphysis of tibial,5 in the metaphysis of humerus,all the lesions combined epiphysis and epiphyseal plate suffering,pyogenic arthritis.2 cases accompanied with subperiosteal abscess,1 case with epiphyseal separation,1 case with dislocation of joint.lesions showed low or slightly low signal on T1WI,high signal on T2WI,PD STIR and GRE.The signal changes were marked especially on PD STIR.（2）metaphysis（3 cases）：2 lesions were located in the metaphysis of femur,1 in the metaphysis of tibial,without epiphysis and epiphyseal plate suffering.lesions showed patchy low or slightly low signal on T1WI,high signal on T2WI.（3）diaphysis（2 cases）：lesions were located in the diaphysis of tibial and raduis.MRI presented as extensive destruction of diaphysis and periosteal reaction,the lesions and adjacent soft tissue presented as patchy heterogeneous enhancement on enhanced MRI scan.Conclusion Acute haematogenous osteomyelitis of long bone in infants has it＇s own feature,recognizing its pathological and MRI characteristics can play an important role in evaluating the severity and prognosis of osteomyelitis.
出处
《临床放射学杂志》
CSCD
北大核心
2012年第3期417-421,共5页
Journal of Clinical Radiology
关键词
婴儿
骨髓炎
磁共振成像
Infants Osteomyelitis Magnetic resonance imaging
