Rizzo P F, Gould E S, Lyden J P, Asnis S E
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City.
J Bone Joint Surg Am. 1993 Mar;75(3):395-401. doi: 10.2106/00004623-199303000-00011.
Sixty-two consecutively seen patients in whom a fracture about the hip was clinically suspected, but in whom the radiographic findings were negative, were examined with both magnetic resonance imaging and bone-scanning. The magnetic resonance-imaging studies, consisting of T1-weighted coronal sections, were done within twenty-four hours after admission to the hospital, and the bone scans, within seventy-two hours after admission. There were twenty-three men and thirty-nine women. Thirty-six patients who had evidence of a fracture on the magnetic resonance-imaging study also had a positive bone scan initially. Twenty-three patients who had a negative finding on the magnetic resonance-imaging study had a corresponding negative bone scan. Two additional patients had evidence of avascular necrosis of the femoral head on both the magnetic resonance image and the bone scan, and they were managed non-operatively. One patient had a positive magnetic resonance image and a negative bone scan twenty-four hours after admission. A repeat bone scan, which was made six days later, was positive for a fracture of the femoral neck and the patient was managed with internal fixation. Magnetic resonance imaging was as accurate as bone-scanning in the assessment of occult fractures of the hip. The magnetic resonance imaging took less than fifteen minutes to perform, and it was tolerated well by the patient. Magnetic resonance imaging provides an early diagnosis of occult fractures about the hip and may decrease the length of the stay in the hospital by expediting definitive treatment.
连续观察了62例临床怀疑有髋部骨折但X线检查结果为阴性的患者，对其进行了磁共振成像（MRI）和骨扫描检查。MRI检查包括T1加权冠状面扫描，在入院后24小时内完成，骨扫描在入院后72小时内完成。患者中男性23例，女性39例。36例MRI检查显示有骨折迹象的患者最初骨扫描也呈阳性。23例MRI检查结果为阴性的患者骨扫描相应为阴性。另外2例患者的MRI和骨扫描均显示股骨头缺血性坏死，对其进行了非手术治疗。1例患者入院后24小时MRI检查结果为阳性但骨扫描为阴性。6天后复查骨扫描，显示股骨颈骨折阳性，该患者接受了内固定治疗。在评估髋部隐匿性骨折方面，MRI与骨扫描一样准确。MRI检查用时不到15分钟，患者耐受性良好。MRI能早期诊断髋部隐匿性骨折，通过加快确定性治疗可缩短住院时间。
