Levinsohn E M
Division of Diagnostic Radiology, SUNY Health Science Center, Syracuse.
Radiol Clin North Am. 1990 Sep;28(5):905-21.
A wide variety of radiologic tools now exists for the assessment of the bones and soft tissues of the wrist. The selection of the most appropriate modality requires that the radiologist be conversant both with this armamentarium and with the needs of the referring clinician requesting diagnostic help. Although most static abnormalities may be nicely displayed on routine plain films and special projections, many dynamic abnormalities require motion or stress views to demonstrate their presence. The three-phase radionuclide bone scan allows the radiologist to judge the acute or chronic nature of the abnormality being assessed. Subluxations involving the distal radioulnar joint are relatively easily recognized with CT scanning through that joint. These abnormalities are seen infrequently and are unreliably diagnosed from the plain film examination alone. Although the triple injection arthrogram seems to be a sensitive and accurate tool for identifying ligamentous perforations including those of the triangular fibrocartilage, the potential for those diagnoses to be made with MR imaging is increasingly recognized.
目前有各种各样的放射学工具可用于评估腕部的骨骼和软组织。选择最合适的检查方式要求放射科医生既要熟悉这些检查手段,又要了解请求诊断帮助的转诊临床医生的需求。尽管大多数静态异常在常规平片和特殊投照中可能显示得很好,但许多动态异常需要进行运动或应力位片来显示其存在。三相放射性核素骨扫描可让放射科医生判断所评估异常的急性或慢性性质。通过对远端桡尺关节进行CT扫描,相对容易识别涉及该关节的半脱位。这些异常情况很少见,仅通过平片检查难以可靠诊断。尽管三联注射关节造影似乎是识别包括三角纤维软骨韧带穿孔在内的韧带穿孔的敏感且准确的工具,但人们越来越认识到磁共振成像在做出这些诊断方面的潜力。