Sakuma M, Nakamura R, Imaeda T
Department of Orthopaedic Surgery, Branch Hospital, Nagoya University School of Medicine, Japan.
J Hand Surg Br. 1995 Apr;20(2):201-5. doi: 10.1016/s0266-7681(05)80050-6.
32 patients with scaphoid non-union were examined to clarify the relationship between pre-operative radiographic sclerosis in the proximal fragment and signal intensity on magnetic resonance imaging (MRI). In addition, the correlation between changes in signal intensity in the proximal fragment and surgical outcome after bone grafting and internal fixation was investigated. Proximal fragment sclerosis was observed in seven patients. Comparison of the T1 and T2-weighted images with those of the 25 patients without proximal fragment sclerosis revealed no differences. Therefore, there was no relationship between sclerotic changes on plain radiography and the degree of avascularity of the proximal fragment assessed by MRI. None of the patients who had low signal intensity on both T1 and T2-weighted images achieved union within 5 months after surgery. Thus the detection of signal intensity on both T1 and T2-weighted images can be useful to predict the prognosis after the surgery.
对32例舟状骨不愈合患者进行检查,以明确近端骨折块术前影像学硬化与磁共振成像(MRI)信号强度之间的关系。此外,还研究了近端骨折块信号强度变化与植骨及内固定术后手术效果之间的相关性。7例患者观察到近端骨折块硬化。将7例有近端骨折块硬化患者的T1加权像和T2加权像与25例无近端骨折块硬化患者的图像进行比较,未发现差异。因此,X线平片上的硬化改变与MRI评估的近端骨折块缺血程度之间没有关系。T1加权像和T2加权像均为低信号强度的患者术后5个月内均未实现骨愈合。因此,T1加权像和T2加权像上信号强度的检测有助于预测手术后的预后。