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[磁共振成像在儿童关节损伤中的治疗相关性]

[Therapeutic relevance of magnetic resonance imaging in joint injuries in children].

作者信息

Schneidmueller D, Maier M, Mack M, Straub R, Marzi I

机构信息

Abteilung für Unfall, -Hand- und Wiederherstellungschirurgie der Johann-Wolfgang-Goethe-Universität Frankfurt.

出版信息

Unfallchirurg. 2005 Jul;108(7):537-43. doi: 10.1007/s00113-005-0936-x.

Abstract

AIM

In this retrospective study, we assessed whether the use of MRI in children provides additional, therapeutically relevant information to assist in the diagnosis of joint injuries. In addition, we determined whether the usefulness of this approach is dependant on age of the child and localisation of the trauma.

METHOD

MRI of 45 children aged between 3 and 16 years were analysed independently by four different investigators (two radiologists, two trauma surgeons) and assessed for their therapeutic relevance.

RESULT

MRI of the knee (n=18) gave additional information in 11 patients (61%) and led to a change in the recommended therapy involving arthroscopy in seven patients (39%). MRI of the ankle (n=21) provided additional information in 12 patients (57%) and the decision for further therapy was influenced in six patients (29%), however, the indication for surgery was not influenced. The diagnosis of injuries of the elbow (n=6) was changed in four patients (67%), but the therapeutic decision was not influenced.

CONCLUSION

MRI additional to conventional x-ray provides relevant information on the therapeutic procedure to be used for the knee, whereas for the ankle and the elbow MRI it rarely delivers additional information relevant to therapeutic decision making.

摘要

目的

在这项回顾性研究中,我们评估了儿童使用磁共振成像(MRI)是否能提供额外的、与治疗相关的信息以辅助关节损伤的诊断。此外,我们还确定了这种方法的有效性是否取决于儿童的年龄和创伤的部位。

方法

由四名不同的研究人员(两名放射科医生、两名创伤外科医生)独立分析45名年龄在3至16岁之间儿童的MRI,并评估其与治疗的相关性。

结果

膝关节MRI(n = 18)在11名患者(61%)中提供了额外信息,导致7名患者(39%)的推荐治疗方案发生改变,涉及关节镜检查。踝关节MRI(n = 21)在12名患者(57%)中提供了额外信息,6名患者(29%)的进一步治疗决策受到影响,然而,手术指征未受影响。肘部损伤(n = 6)的诊断在4名患者(67%)中发生了改变,但治疗决策未受影响。

结论

除传统X线检查外,MRI能提供有关膝关节治疗程序的相关信息,而对于踝关节和肘部MRI,它很少能提供与治疗决策相关的额外信息。

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