Deutsch A L, Mink J H, Waxman A D
Department of Diagnostic Radiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Radiology. 1989 Jan;170(1 Pt 1):113-6. doi: 10.1148/radiology.170.1.2909083.
Coronal T1-weighted magnetic resonance (MR) images were obtained on a 1.5-T system in 23 patients in whom there was a high clinical suspicion of hip fracture although initial radiographs were normal. MR imaging correctly demonstrated fracture in nine of nine patients; the precise configuration of the fracture line was delineated in eight patients. MR imaging was useful in excluding fractures in 14 of 14 patients, who were subsequently followed up clinically for a minimum of 3 months. Radionuclide scans were positive in four of four patients with fractures and equivocal in one patient who was subsequently demonstrated to have no fracture. Additional imaging studies were requested by clinicians in all cases in which the bone scan was positive. The results of this study suggest that MR imaging can provide a rapid, cost-effective, and anatomically precise diagnosis of hip fracture in patients with normal or equivocal initial radiographs. The specificity of the diagnosis achieved can obviate supplemental imaging examinations, with their attendant additional expense and radiation exposure.
对23例临床高度怀疑髋部骨折但初始X线片正常的患者，在1.5-T系统上进行了冠状位T1加权磁共振（MR）成像检查。MR成像正确显示了9例患者中的9例骨折；8例患者中骨折线的精确形态得以描绘。MR成像有助于排除14例患者中的骨折，这些患者随后接受了至少3个月的临床随访。放射性核素扫描在4例骨折患者中呈阳性，在1例随后被证实无骨折的患者中结果不明确。在骨扫描呈阳性的所有病例中，临床医生均要求进行额外的影像学检查。本研究结果表明，MR成像可为初始X线片正常或不明确的患者提供快速、经济有效且解剖结构精确的髋部骨折诊断。所实现诊断的特异性可避免进行补充影像学检查及其带来的额外费用和辐射暴露。
