摘要
目的分析膝关节应力性骨折的X线平片与MRI表现。方法搜集资料齐全且经临床治疗并随访证实的膝关节应力性骨折23例,所有病例均行膝关节MRI常规冠状面T1WI、T2STIR、矢状面T1WI、T2WI平扫,19例同时行X线平片检查。结果 (1)23例膝关节应力性骨折中,15例位于胫骨内侧髁,3例位于胫骨外侧髁,4例位于股骨内侧髁,1例位于股骨外侧髁;所有病例X线平片与MRI均未见骨质破坏、骨膜反应及软组织肿块。(2)X线平片表现:19例骨皮质均连续,未见断裂征象;5例胫骨髁、1例股骨髁松质骨内示不规则水平条状高密度影,边界部分欠清,位于骨骺线附近,与骺线走行一致,此6例中,3例邻近软组织稍肿胀;余13例未见异常或骨质疏松表现。(3)MRI平扫表现:23例胫、股骨内或外侧髁松质骨内片状或大片状骨髓水肿,内见不规则短或长条状更长T1、短T2信号,位于骨骺线附近,与骺线走行一致,邻近软组织轻度水肿,其中5例示骨折线邻近骨皮质断裂。结论膝关节应力性骨折好发于胫骨内侧髁,X线平片和MRI平扫具有特征性表现,MRI敏感性明显高于X线平片,结合病史,MRI可对其作出较准确诊断。
Objective To analyze the X-ray and MRI features of stress fracture of knee joint. Methods A total of 23 cases with clinically-confirmed stress fracture of knee joint who had complete medical information and materials were enrolled in this study. Routine plain MRI T1WI and T2STIR of knee joint coronal plane as well as T1WI and T2WI of knee joint sagittal plane were performed in all patients. Additional radiography of knee joint was employed in 19 cases. Results （ 1 ） Of the 23 cases, the fracture was located at condylus medialis tibiae in 15, at condylus lateralis tibiae in 3 and at condylus lateralis femoris in 4. No destruction of bone, periosteal reaction or soft tissue mass was observed on radiograph and MRI scan. （2） Radiograph showed that the cortical bone was continuous and no fracture sign was seen ; fracture of tibia condyles was found in 5 cases and in one case the femur condyle cancellous bone showed horizontal high density strip with blur border which was parallel and close to the epiphyseal line. The adjacent soft tissue swelling was observed in 3 cases. （3） Plain MRI scanning demonstrated that large extent bone marrow edema was seen in the cancellous bone of tibia and femur condyles, irregular short or long strip longer-T1 , short-T2 signals were seen in the area near the epiphyseal line, and adjacent soft tissue was slightly swelling. Cortical bone fracture was revealed in 5 cases. Conclusion Knee joint stress fracture is prone to occur at the medial condyle of the tibia, which has characteristic manifestations on both radiograph and plain MRI. The diagnostic sensitivity of MRI is obviously higher than radiograph. Combined with clinical history, MRI can make more accurate diagnosis .
出处
《临床放射学杂志》
CSCD
北大核心
2014年第12期1910-1914,共5页
Journal of Clinical Radiology
关键词
膝关节
应力性骨折
X线平片
磁共振成像
Knee joint Stress fracture Plain X-ray film Magnetic resonance imaging
