胫骨上段疲劳性骨折CT、MRI表现.pdfVIP

· 1672· 实用放射学杂志2007年 12月第23卷第12期 J Pract Radiol，Dec．2007，Vo1．23，No．12 胫骨上段疲劳性骨折CT、MRI表现 孙风霞，李玉侠，韩东明，李长松，刘永天 (河南新乡医学院第一附属医院放射科，河南 卫辉 453100) 摘要：目的 探讨胫骨上段疲劳骨折的CT与MRI表现及其形成机制。方法 分析经临床随访或手术证实的23例胫骨上段 疲劳性骨折的CT和MRI资料。23例均行x线及 CT检查，7例行 MRI检查。结果 23例胫骨上段疲劳骨折均发生在距胫骨膝关 节面约5．5—8．5 am之间，CT检查23例在胫骨中上段后方见单层、多层或花边样骨膜增生，其后缘正中略偏内侧见脐样凹陷切迹。 16例见斜行骨折线。2O例骨皮质松化，23例均表现局部骨髓腔密度增高，未见软组织肿块。MRI表现骨折线及骨膜增生在T WI 和T wI均呈低信号，骨折线上下邻近髓腔及周围软组织呈边缘模糊的长T 长T 信号。脐样凹陷切迹处见条状长T 短T 信号。 结论 胫骨上段疲劳骨折的CT表现具有特征性，MRI检查对早期诊断具有较大价值。 关键词：骨；疲劳性骨折；胫骨；体层摄影术，x线计算机；磁共振成像 中图分类号：R683．42；R814．42；R445．2 文献标识码：A 文章编号：1002—1671(2007)12—1672—04 CT and MRI Findings of Fatigue Fracture in the Proximal Segment of Tibia SUN Feng—xia。LI Yu—xia。HAN Dong—ming。LI Chang—song。LIU Yong—tian (Department of Radiology，the First Affiliated Hospital of Xinxiang Medical College。 Weihui， ’nan Province 453100。China) Abstract：0bjective To evaluate the CT and MRI findings and the mechanisms of fatigue fracture in the proximal part of tibia．Meth- ods CT and MRI findings of 23 cases with fatigue fracture in the proximal part of tibia confirmed by operation and／or clinical diagnosis were retrospectively analyzed．All cases were undergone radiography and CT scans。7 cases underwent MRI．Results The fractures in 23 cases were all at 5．5 am to 8．5 am distant from the articular surface of tibia．On CT。monolayer。muhilayer or lace—form periosteal reaction were found at the proximal part of the tibias in all cases，and there was umbilicated incisure at medial side near the middle of back part of the tibia． Oblique fracture lines in 16 cases。osteoporosis of the cortex in 20 cases and the density of medullary cavities in 23 cases were seen，there were no soft tissue masses．All the fracture lines and periosteal reaction were low signal intensity on T1 WI and T2