本文關(guān)鍵詞：骨梗死影像學(xué)表現(xiàn)及其病理學(xué)基礎(chǔ)，由筆耕文化傳播整理發(fā)布。

骨梗死影像學(xué)表現(xiàn)及其病理學(xué)基礎(chǔ)

Pathological basis and imaging findings of bone infarction

[1] [2] [3] [4] [5] [6] [7] [8] [9]

CUI Guang-bin, WANG Wei, SONG Li-jun, QIN Yue, GUO Wei, DU Pang , LI Wei , XIONG Xiao-shuang WEI Jing-guo （Department of Radiology, Tangdu Hospital, Fourth Military Medica

第四軍醫(yī)大學(xué)唐都醫(yī)院放射科,陜西西安710038

文章摘要：目的 探討骨梗死的影像學(xué)表現(xiàn)及其病理學(xué)基礎(chǔ)。方法 回顧性分析對(duì)臨床隨訪及穿刺活檢病理證實(shí)的11例骨梗死X線平片、CT及MRI征象，并結(jié)合骨梗死早、中晚期病理改變，總結(jié)其影像學(xué)特征。結(jié)果 病變主要累及股骨下端和脛骨上端。骨梗死早期X線、CT陰性或僅局部骨小梁模糊，，MRI表現(xiàn)為骨梗死灶中心區(qū)呈等至短T1、T2信號(hào)改變，周邊環(huán)繞花邊狀長(zhǎng)T1、長(zhǎng)T2信號(hào)帶，示梗死灶內(nèi)出血腫脹，與正常骨髓間有充血水腫;中晚期X線、CT表現(xiàn)為斑片狀、條索狀及不規(guī)則骨質(zhì)硬化和鈣化;MRI表現(xiàn)為病變中心等或稍長(zhǎng)T1、T2信號(hào)改變;病灶邊緣T1WI呈花邊狀低信號(hào)帶，T2WI呈內(nèi)層為高信號(hào)、外層為低信號(hào)的雙信號(hào)帶。最后MRI呈長(zhǎng)T1、短T2信號(hào)影，示壞死組織被肉芽組織和纖維組織替代而發(fā)生纖維化和鈣化或骨化。結(jié)論 骨梗死的各期有不同的影像學(xué)表現(xiàn)和相應(yīng)的病理學(xué)基礎(chǔ)，MRI發(fā)現(xiàn)早期病變較平片和CT敏感，中晚期平片、CT和MRI均具有特征性表現(xiàn)，而MRI是本病最好的檢查手段。

Abstr：Objective To explore the imaging manifestations and their related pathological basis of bone infarction.. Methods The plain radiography, CT and MRI images of eleven cases of bone infarction which were confirmed by pathological puncture biopsy and clinical follow up visit were analyzed retrospectively. Their image features were summarized with their pathological changes of early, middle and late stages. Results Most of the infarction sites were distal femur and proximal tibia. In early stage, the major image findings of plain radiography and CT were negative or only a slight dim of local bone trabecula, and the major MRI manifestations were iso/short T1/T2 signal changes in the center of the foci and lace-like long T1/T2 signal zone around the foci, reflecting edema and hemorrhage within the infarction, and congestive edema between the foci and normal marrow. In the late stage of the infarction, the major image changes of plain radiography and CT were patching, trabs and irregular shaped punctate calcifications, the major MRI manifestations were iso/long T1/T2 signal changes in the center of the foci and appearance of lace-like low T1WI signal zone around the foci, two layers of T2WI signal zone which was low at out layer and high at inner layer was also observed. Another MRI manifestation was long T1 and short T2 signals, reflecting that the necrotic tissue were replaced by granulation tissue and fibrous tissue, and a fibrosis and calcification/ossification process occurred. Conclusion The imaging features of bone infarction and their related pathological basis are different at different stages. In early stage, MRI is more effective to the diagnosis of bone infarction than plain radiography and CT, in

文章關(guān)鍵詞：

Keyword：:Bone infarction Radiography Magnetic resonance imaging Pathology

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  本文關(guān)鍵詞：骨梗死影像學(xué)表現(xiàn)及其病理學(xué)基礎(chǔ)，由筆耕文化傳播整理發(fā)布。