Ye Da-Chun, Qiu Qian-De, Yin Jing-Chun
Department of Radiology, Third People's Hospital of Wenzhou, Wenzhou 325000, Zhejiang, China.
Zhongguo Gu Shang. 2010 Jun;23(6):427-9.
To investigate the MRI diagnosis of bone contusion on the knee, and improve the diagnosis skill.
A retrospective analysis of 47 cases of knee bone bruise with the performance of MRI in our hospital from 2008.5 to 2009.12, including 30 males and 17 females,aged from 12 to 69 years, with a mean of 34.5 years old. Forty-seven patients suffered from post-traumatic localized pain, tenderness and(or) soft tissue swelling and dysfunction. The time interval between the accident and the MRI examination ranged from 6 h to 30 days, averaged 7 days. The patients with only bone contusion were treated with conservative and symptomatic treatment.
A total of 47 cases showed 82 lesions, including 39 distal femur, 35 proximal tibias (including the tibial plateau),5 patellas, 3 fibula top. MRI showed irregular patchy or map-like T1WI low signal, isointensity or slightly high signal intensity T2WI, STIR fat suppression all showed obviously high signal, in which 20 patients with torn meniscus, collateral ligament injuries in 14 cases, anterior cruciate ligament injuries in 8 cases. The X-ray and CT examination of all the patients revealed no signs of fracture. The clinical symptoms and signs of all the patients significantly reduced or disappeared after treatment. Among 29 patients who were followed up from 1 to 12 months, 21 patients had abnormal MRI signal disappearing and 8 patients had abnormal signal weakened.
MRI can reveal pathological changes of bone contusion on the knee, and accurately determine ligaments around the joint and soft tissues injuries. Conventional MRI examination and fat-suppression sequence is the most valuable method of bone contusion.
探讨膝关节骨挫伤的MRI诊断,提高诊断技术。
回顾性分析我院2008年5月至2009年12月行MRI检查的47例膝关节骨挫伤患者,其中男30例,女17例,年龄12~69岁,平均34.5岁。47例患者均有外伤后局部疼痛、压痛及(或)软组织肿胀、功能障碍。外伤至MRI检查时间间隔6 h至30 d,平均7 d。单纯骨挫伤患者行保守及对症治疗。
47例共显示82处病灶,其中股骨远端39处,胫骨近端35处(包括胫骨平台),髌骨5处,腓骨小头3处。MRI表现为T1WI呈不规则斑片状或地图样低信号,T2WI等信号或稍高信号,STIR脂肪抑制像均呈明显高信号,其中合并半月板撕裂20例,侧副韧带损伤14例,前交叉韧带损伤8例。所有患者X线及CT检查均未发现骨折征象。所有患者经治疗后临床症状及体征均明显减轻或消失。29例随访1~12个月,21例MRI异常信号消失,8例异常信号减弱。
MRI能显示膝关节骨挫伤的病理改变,并能准确判断关节周围韧带及软组织损伤情况。常规MRI检查及脂肪抑制序列是诊断骨挫伤最有价值的方法。