Department of Medical Imaging, University Hospital, Heraklion, Greece; Department of Medical Imaging, General Hospital of Sitia, Lasithi, Greece.
Department of Medical Imaging University Hospital, Heraklion, Greece; Imperial College London, London, United Kingdom.
Diagn Interv Radiol. 2019 May;25(3):245-250. doi: 10.5152/dir.2019.18354.
Pregnancy is a normal condition in which a combination of biomechanical and hormonal changes may result in a wide spectrum of skeletal disorders. Skeletal overloading due to postural and weight changes, combined with increased ligamentous laxity stemming from the action of relaxing and the risk of pregnancy-related osteoporosis during childbearing, childbirth, and postpartum, have been associated with various pathologies. Owing to the heterogeneity of proposed contributing factors, skeletal lesions in the peripartum period may be related to different pathogenesis depending on the metabolic status of the patient and the degree of biomechanical stress; thus, a fatigue or insufficiency discrimination is not always easy to make. When combined with clinical data, magnetic resonance imaging (MRI) is a powerful tool in clarifying the cause of skeletal pain in the majority of patients or alerting clinicians to proceed to further investigations. Early detection and tailored treatment are important in order to avoid disease progression and long-term restriction of daily activities which may have an adverse impact on the relationship between the mother and the newborn. This pictorial essay provides an overview of the MRI characteristics and pattern of involvement of skeletal lesions presenting during the peripartum period, combined with demographic data and dual-energy X-ray absorptiometry (DEXA) measurements.
妊娠是一种正常状态,其中生物力学和激素变化的组合可能导致广泛的骨骼疾病。由于姿势和体重的变化导致的骨骼过载,加上松弛作用引起的韧带松弛增加,以及妊娠相关骨质疏松症的风险,在生育、分娩和产后期间,都与各种病理有关。由于提出的致病因素的异质性,围产期的骨骼病变可能与不同的发病机制有关,具体取决于患者的代谢状态和生物力学应激程度;因此,疲劳或不足的鉴别并不总是容易做出。当与临床数据结合时,磁共振成像(MRI)是阐明大多数患者骨骼疼痛原因的有力工具,或提醒临床医生进一步进行检查。早期发现和针对性治疗很重要,以避免疾病进展和长期限制日常活动,这可能会对母婴关系产生不利影响。本文图册概述了围产期出现的骨骼病变的 MRI 特征和受累模式,并结合了人口统计学数据和双能 X 射线吸收法(DEXA)测量结果。