Peterson Jeffrey J, Bancroft Laura W, Kransdorf Mark J
Department of Radiology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224-3899, USA.
AJR Am J Roentgenol. 2002 Mar;178(3):557-62. doi: 10.2214/ajr.178.3.1780557.
The purpose of this study was to identify the characteristic imaging features of wooden foreign bodies.
The imaging studies of 12 patients with surgically confirmed wooden foreign bodies were retrospectively reviewed. The study group consisted of seven females and five males, 10-65 years old (mean age, 36 years). All patients underwent radiography. Nine patients were evaluated with sonography, eight with MR imaging, three with CT, and one with CT arthrography. Gadolinium-enhanced MR imaging was performed in six patients. Three patients presented with a draining sinus and nine with painful swelling. Only three patients presented with a history of penetrating injury.
Lesions were located in the foot (n = 4), hand (n = 3), thigh (n = 2), calf (n = 2), and elbow (n = 1). Radiographs failed to reveal the retained foreign bodies in all patients. With MR imaging, wooden foreign bodies displayed a variable signal intensity that was equal to or less than that of skeletal muscle on both T1- and T2-weighted images. MR imaging showed the surrounding inflammatory response in all patients. CT showed the retained wood as linear cylindric foci of increased attenuation. Wood was highly echogenic and revealed pronounced acoustic shadowing on sonography. Arthrography in one patient showed an associated reactive synovitis.
The imaging appearance of wooden foreign bodies is variable; however, imaging can be quite specific, and when taken in the appropriate clinical setting, the imaging should reliably suggest the diagnosis. Sonography is frequently underused but proved most useful for the evaluation of retained wooden foreign bodies.
本研究旨在确定木质异物的特征性影像表现。
回顾性分析12例经手术证实存在木质异物患者的影像检查资料。研究组包括7名女性和5名男性,年龄10 - 65岁(平均年龄36岁)。所有患者均接受了X线摄影检查。9例患者接受了超声检查,8例接受了磁共振成像(MR成像)检查,3例接受了CT检查,1例接受了CT关节造影检查。6例患者进行了钆增强MR成像检查。3例患者出现引流窦道,9例患者出现疼痛性肿胀。只有3例患者有穿透伤病史。
病变位于足部(4例)、手部(3例)、大腿(2例)、小腿(2例)和肘部(1例)。所有患者的X线片均未显示残留的异物。在MR成像中,木质异物在T1加权像和T2加权像上显示出与骨骼肌相等或更低的可变信号强度。MR成像显示所有患者周围均有炎症反应。CT显示残留的木质异物为线性圆柱形高密度灶。木质异物在超声检查中表现为高回声,并伴有明显的声影。1例患者的关节造影显示伴有反应性滑膜炎。
木质异物的影像表现具有多样性;然而,影像学表现可能非常具有特异性,在适当的临床背景下,影像学表现应能可靠地提示诊断。超声检查经常未得到充分利用,但事实证明其对评估残留木质异物最为有用。