低场MRI成像对膝关节外伤诊断价值.docVIP

低场MRI成像对膝关节外伤诊断价值【摘要】 目的 探讨低场MRI对膝关节外伤的诊断价值及MRI表现。方法 对经临床或手术证实的48例膝关节外伤患者行低场MRI检查,分析、总结MRI表现。采用0.32T低场MR扫描机,常规应用冠状位和矢状位SE序列、GRE 序列及脂肪抑制STIR 序列T1WI、T2WI 成像。结果 骨挫伤及骨折32例； 关节囊积液18例；半月板损伤24例；后交叉韧带撕裂伤2例；内侧副韧带撕裂伤9例；外侧副韧带撕裂伤8例；仅3例未见异常。结论 低场MRI可以很好显示膝关节损伤后的各种表现, 可作为膝关节外伤后检查的首选或重要手段。? 【关键词】 膝关节;外伤；低场磁共振成像 The value of MR imaging with low field intensity in knee joint injury SHAO Song-ming, WANG Yong,WANG Qi-tao. Department of CT and MRI,Miner No.2 Hospital of Xuzhou City,Jiangsu221011，China ? 【Abstract】 Objective To analyze the MRI findings of knee joint injury and assess the diagnostic value of the low field intensity MR.Methods The MR findings of 48 injured knee joints confirmed clinically or surgically were retrospectively reviewed and evaluated.Sagittal and coronal scanning with SE T1W sequences were used at 0.32T MR scanner. Results Bony contusion and fracture was 32 cases, joint effusion was 18 cases，meniscal tear was 24 cases,posterior cruciate ligament sprang was 2 cases，the tibial collateral ligament sprains in 9 cases，the fibular collateral ligament sprains in 8 cases，but only 3 cases no abnormalities were found.Conclusion The low field intensity MR can accurately demonstrate the appearances of knee injury. It should be used as an important or routine method in diagnosis of knee injury.? 【Key words】 Knee joint;Trauma;Low field MRI 膝关节为人体中最大、最复杂、活动最多的负重关节，在各种外伤中损伤机率最多，运用常规X线或CT检查常不能发现半月板及韧带的损伤,亦不能发现骨质损伤或隐性骨折,而MR检查具有良好的软组织对比度和高空间分辨率,对膝关节半月板、韧带、软组织及骨质的损伤显示清楚。本文总结48例经低场MRI检查的患者资料,以进一步提高对膝关节损伤的诊断能力。? 1 资料与方法? 1.1 一般资料 回顾性收集我院2006年1月至2008年6月膝部有典型的外伤史，首次MRI检查时间为外伤后1 d～6个月不等。48例患者中，有阳性发现的病例45例，阳性率93.7％，男33例，女12例，年龄22～65岁，平均41岁。致伤原因：车祸19例；摔伤12例；扭伤9例;其他8例。? 1.2 检查方法 全部病例均使用采用三星公司0.32T开放式永磁型MR扫描机,使用膝关节专用线圈，先行自旋回波SE序列矢状位、冠状位T1WI(TR/TE=570 ms/23 ms)、快速自旋回波FSE矢状位、冠状位T2WI(TR/TE=3000 ms/88 ms)扫描；层厚4 mm，间距1 mm，连续扫描20层。在此基础上，选择性进行脂肪抑制、T2水抑制矢状位、冠状位或横轴位检查。FOV 200 mm,矩阵256×392，激励次数为2～3次。? 2 结果? 半月板损伤24例，其中内侧14例，外侧10例；表现为半月板内达到软骨面SE序列T1WI、T2W