Quinn S F, McCarthy J L
Department of Radiology, Good Samaritan Hospital, Portland, OR 92710.
Radiology. 1993 May;187(2):469-71. doi: 10.1148/radiology.187.2.8475292.
To assess the diagnostic efficacy of T1-weighted magnetic resonance (MR) images when findings on radiographs of the hip are indeterminate, 20 patients with suspected hip fracture and indeterminate radiographs were prospectively evaluated. MR imaging was performed with surface coil technique; one coronal T1-weighted (repetition time msec/echo time msec = 400/19) MR image was obtained. The total charge for the examination was $448 (compared with the following usual charges: radionuclide bone scan, $455; tomography, $299; and computed tomography, $797). When MR imaging and clinical outcome were used as the standard of reference, the prospective accuracy of MR imaging in diagnosis of the presence or absence of hip fracture was 100% (20 correct diagnoses). All MR studies were diagnostic. Of the 13 patients with fracture (eight with trochanteric and five with subcapital fracture), 10 patients (77%) underwent surgery and three patients (23%) received conservative treatment. T1-weighted MR images can enable diagnosis or exclusion of hip fracture whenever radiographs are indeterminate. The imaging time is approximately 7 minutes, and the cost of the examination can be made competitive with costs of other advanced imaging examinations.
为评估当髋部X线片检查结果不明确时，T1加权磁共振（MR）图像的诊断效能，对20例疑似髋部骨折且X线片检查结果不明确的患者进行了前瞻性评估。采用表面线圈技术进行MR成像；获得一张冠状面T1加权（重复时间毫秒/回波时间毫秒 = 400/19）MR图像。该检查的总费用为448美元（与以下常规费用相比：放射性核素骨扫描，455美元；断层扫描，299美元；计算机断层扫描，797美元）。以MR成像和临床结果作为参考标准时，MR成像诊断髋部骨折是否存在的前瞻性准确率为100%（20例诊断正确）。所有MR检查均具有诊断价值。在13例骨折患者中（8例转子间骨折和5例股骨头下骨折），10例患者（77%）接受了手术治疗，3例患者（23%）接受了保守治疗。只要X线片检查结果不明确，T1加权MR图像就能确诊或排除髋部骨折。成像时间约为7分钟，且该检查的费用可与其他先进成像检查的费用相竞争。
