McKenzie Gavin A, Niederhauser Blake D, Collins Mark S, Howe Benjamin M
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Skeletal Radiol. 2016 Aug;45(8):1053-60. doi: 10.1007/s00256-016-2374-y. Epub 2016 Apr 20.
To highlight the significance and imaging characteristics of Morel-Lavallée (ML) lesions, which have been well characterized on MRI, but are potentially under-recognized on CT.
Twenty-eight Morel-Lavallée lesions were identified in 18 patients and were all clinically or surgically confirmed. Lesions were grouped into acute (<3 days), subacute (3-30 days), and chronic (>30 days) at the time of CT imaging. Charts were reviewed to gather patient characteristics, injury patterns, radiologist interpretation, treatment, and outcomes.
Sixteen male and 2 female patients with a mean age of 50 years (range 19-80) at the date of their initial evaluation were identified. All patients had significant trauma that accounted for 28 ML lesions, all of which were in a characteristic subcutaneous location overlying the muscular fascial plane. Lesions on CT went through an evolution from hyperdense, poorly or moderately marginated without a pseudocapsule to being hypodense, with internal fat globules or septations and well marginated with a complete enhancing pseudocapsule. Only 1 (4 %) of the ML lesions was suggested and 7 (25 %) lesions were not commented on at all by the interpreting radiologist.
Morel-Lavallée lesions are post-traumatic closed, internal, soft-tissue, degloving lesions that are potentially underrecognized on CT. Most acute ML lesions are nonspecific, resembling simple hematomas or contusions. ML lesions evolve as they age with subacute and chronic lesions demonstrating the known features described on MR imaging that should allow for an accurate imaging diagnosis.
强调莫雷尔-拉瓦利（ML）损伤的重要性及影像学特征，该损伤在磁共振成像（MRI）上已有明确特征，但在计算机断层扫描（CT）上可能未得到充分认识。
在18例患者中识别出28处莫雷尔-拉瓦利损伤，均经临床或手术证实。在CT成像时，将损伤分为急性（<3天）、亚急性（3 - 30天）和慢性（>30天）。查阅病历以收集患者特征、损伤模式、放射科医生的解读、治疗及结果。
确定了16例男性和2例女性患者，初次评估时平均年龄为50岁（范围19 - 80岁）。所有患者均有严重创伤，导致28处莫雷尔-拉瓦利损伤，所有损伤均位于肌肉筋膜平面上方的特征性皮下位置。CT上的损伤经历了从高密度、边界不清或中等边界且无假包膜到低密度、有内部脂肪球或分隔且边界清晰并有完整强化假包膜的演变过程。解读的放射科医生仅提示了1处（4%）莫雷尔-拉瓦利损伤，7处（25%）损伤完全未被提及。
莫雷尔-拉瓦利损伤是创伤后闭合性、内部软组织脱套伤，在CT上可能未得到充分认识。大多数急性莫雷尔-拉瓦利损伤是非特异性的，类似单纯血肿或挫伤。莫雷尔-拉瓦利损伤随时间演变，亚急性和慢性损伤呈现出磁共振成像上已知的特征，这应有助于准确的影像学诊断。
