Morrison W B, Schweitzer M E, Wapner K L, Hecht P J, Gannon F H, Behm W R
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Radiology. 1995 Aug;196(2):557-64. doi: 10.1148/radiology.196.2.7617877.
To evaluate sensitivity, specificity, clinical utility, and cost-effectiveness of magnetic resonance (MR) imaging in the diagnosis of osteomyelitis of the foot in diabetics.
MR studies of 62 feet (diabetics [n = 27], nondiabetics [n = 35]) in 59 patients were prospectively evaluated to detect the presence and extent of osteomyelitis. Biopsy (n = 41 feet) and clinical follow-up (n = 62 feet) were used to establish the diagnosis, select treatment, and determine outcome; sensitivity and specificity of MR imaging were calculated. A cost analysis was performed.
Sensitivity and specificity of MR imaging in the diagnosis of osteomyelitis were 82% and 80%, respectively, in diabetics and 89% and 94%, respectively, in nondiabetics. There was no recurrent infection at the surgical margin in 13 feet in which the area of limited resection had been delineated at MR imaging.
MR imaging shows good sensitivity and specificity for diagnosing osteomyelitis in diabetic feet, and it is competitively priced compared with other imaging modalities. Accurate delineation of extent allows limited surgical resection, making MR imaging clinically useful and cost-effective.
评估磁共振（MR）成像在诊断糖尿病患者足部骨髓炎中的敏感性、特异性、临床实用性及成本效益。
前瞻性评估了59例患者的62只足部（糖尿病患者[27只]，非糖尿病患者[35只]）的MR研究，以检测骨髓炎的存在及范围。采用活检（41只足部）及临床随访（62只足部）来确立诊断、选择治疗方法并确定预后；计算MR成像的敏感性及特异性。进行了成本分析。
MR成像诊断糖尿病患者骨髓炎的敏感性及特异性分别为82%和80%，诊断非糖尿病患者骨髓炎的敏感性及特异性分别为89%和94%。在MR成像中已划定有限切除区域的13只足部，手术切缘未出现反复感染。
MR成像对诊断糖尿病足骨髓炎具有良好的敏感性和特异性，与其他成像方式相比价格具有竞争力。准确划定范围可实现有限的手术切除，使MR成像具有临床实用性且成本效益高。
