Mellerowicz H, Lubasch A, Dulce M C, Dulce K, Wagner S, Wolf K J
Orthopãdische Klinik und Poliklinik, Freien Universität Berlin.
Rofo. 1997 May;166(5):437-45. doi: 10.1055/s-2007-1015454.
To clarify the value of plain and contrast-enhanced MRI for the diagnosis and follow-up of muscle injuries, by means of experimental and clinical studies.
24 Wistar rats were studied following standardized division of the calf muscles by means of MRI carried out on the first day, and also after one, two, three and four weeks. In addition, 16 patients with muscle injuries were examined (32 examinations), first between the first and fifth day of trauma, and subsequently over a period of two to seven weeks (average: four weeks).
In the animal experiments, there was signal reduction of T1 and an increase of the T2-weighted signal during the acute inflammatory phase. During the subacute reparative phase, there was an increase of both the T1-weighted and T2-weighted signals. These became reduced during the chronic healing phase. Early differentiation between intramuscular haematomas and bleeding, surrounding oedema and recognition of the divided muscle fibres was possible only after the intravenous injection of an MR contrast medium (Gd-DTPA). Suture of the divided muscles resulted in more rapid healing without major defects.
It is possible to follow up the healing process after muscle injuries by means of plain MR. Contrast-enhanced MR allows early evaluation of muscle abnormalities, and is particularly valuable for recognising the margins of the injured muscles.
通过实验和临床研究，阐明平扫及增强MRI在肌肉损伤诊断及随访中的价值。
对24只Wistar大鼠进行研究，于第一天通过MRI对小腿肌肉进行标准化划分，并在1周、2周、3周和4周后再次进行MRI检查。此外，对16例肌肉损伤患者进行了检查（共32次检查），首次检查在创伤后的第1天至第5天之间，随后在2至7周（平均4周）的时间段内进行随访检查。
在动物实验中，急性炎症期T1信号降低，T2加权信号增加。亚急性修复期，T1加权和T2加权信号均增加。在慢性愈合期信号降低。只有在静脉注射MR造影剂（钆喷酸葡胺）后，才有可能早期区分肌肉内血肿与出血、周围水肿以及识别断裂的肌纤维。对断裂肌肉进行缝合可使愈合更快且无明显缺损。
通过平扫MR可以随访肌肉损伤后的愈合过程。增强MR能够对肌肉异常进行早期评估，对于识别损伤肌肉的边界尤其有价值。
