髋关节和膝关节置换术后的磁共振成像。
MR imaging after hip and knee replacement.
作者信息
Koch Sebastian, Forteza Alejandro, Lavernia Carlos, Romano Jose G, Campo Nelly, Bhatia Rita, Campo-Bustillo Iszet
机构信息
Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
出版信息
J Neuroimaging. 2007 Oct;17(4):332-5. doi: 10.1111/j.1552-6569.2007.00157.x.
BACKGROUND
Diffusion-weighted (DW) imaging abnormalities often develop in patients after invasive procedures associated with cerebral microembolism. Cerebral microembolism has recently been shown during orthopedic surgery. We here examine the effects of intraoperative microembolism on acute magnetic resonance(MR) imaging in patients undergoing hip and knee replacement.
METHODS
We enrolled 24 patients, at least 65 years old, requiring elective knee or hip replacement surgery. MR with DW and axial fluid-attenuated inversion recovery (FLAIR) imaging was performed pre- and postoperatively. All patients were monitored intraoperatively for microemboli.
RESULTS
The mean age of patients was 74 years. All patients had intraoperative microemboli. The mean number of emboli detected was 9.9 +/- 18 per surgery. MR imaging was obtained a mean of 3.5 days postoperatively. No DW imaging abnormalities were found after surgery. One patient had new findings on postoperative FLAIR imaging.
CONCLUSION
Intraoperative microembolism occurred universally, but did not lead to acute DW imaging abnormalities following knee and hip replacement. Acute imaging abnormalities on FLAIR imaging are rare but may occasionally occur after joint surgery.
背景
在与脑微栓塞相关的侵入性手术后，患者常出现弥散加权（DW）成像异常。最近在骨科手术中已证实存在脑微栓塞。我们在此研究术中微栓塞对接受髋关节和膝关节置换术患者急性磁共振（MR）成像的影响。
方法
我们纳入了24例至少65岁、需要择期膝关节或髋关节置换手术的患者。术前和术后均进行了带有DW及轴位液体衰减反转恢复（FLAIR）成像的MR检查。所有患者术中均监测微栓子。
结果
患者的平均年龄为74岁。所有患者术中均有微栓子。每次手术检测到的栓子平均数量为9.9±18个。术后平均3.5天进行了MR成像。术后未发现DW成像异常。1例患者术后FLAIR成像有新发现。
结论
术中微栓塞普遍发生，但膝关节和髋关节置换术后并未导致急性DW成像异常。FLAIR成像上的急性成像异常很少见，但在关节手术后可能偶尔会出现。
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