Voigt C, Ewig M, Vosshenrich R, Lill H
Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Humboldtstr. 5, 30169, Hannover.
Unfallchirurg. 2010 May;113(5):378-85. doi: 10.1007/s00113-009-1662-6.
The diagnostic value of X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) for proximal humeral fractures (PHF) was compared in order to test the hypothesis that MRI gives relevant additional information.
In this study 30 displaced PHFs were investigated with X-ray, CT and MRI procedures. Fracture analysis was performed and the diagnostic values of the three methods were compared to each other. In the MRI relevant musculotendinous concomitant injuries and prognostic factors of the head perfusion were also evaluated.
In 7 out of 30 PHFs the X-rays did not show the correct number of fragments. The posteromedial metaphyseal extension and the caput-diaphysis angle were measured to be significantly greater in the X-rays than in CT and MRI. Relevant additional information obtained by MRI were 7 out of 30 rotator cuff tears and 11 out of 30 differentiated medial periostal hinges.
X-ray imaging is the basis method for the diagnosis of PHF but needs further multiplanar imaging to demonstrate complete fracture patterns. Imaging of fractures is equally good for MRI and CT and MRI also provides additional therapy-relevant information about the rotator cuff and head perfusion.
比较X线、计算机断层扫描（CT）和磁共振成像（MRI）对肱骨近端骨折（PHF）的诊断价值，以验证MRI能提供相关额外信息这一假设。
本研究对30例移位的PHF患者进行了X线、CT和MRI检查。进行了骨折分析，并比较了三种方法的诊断价值。在MRI检查中，还评估了相关的肌腱伴随损伤和头部灌注的预后因素。
30例PHF患者中，7例X线未显示正确的骨折块数量。X线测量的后内侧干骺端延伸和骨干-骨骺角明显大于CT和MRI测量值。MRI获得的相关额外信息包括30例中有7例肩袖撕裂，30例中有11例鉴别出内侧骨膜铰链。
X线成像是诊断PHF的基础方法，但需要进一步的多平面成像来显示完整的骨折模式。MRI和CT对骨折的成像效果相同，MRI还提供了有关肩袖和头部灌注的与治疗相关的额外信息。
