Breitenseher M J, Gaebler C
Department of Radiology, University of Vienna AKH, Austria.
Eur J Radiol. 1997 Sep;25(2):129-39. doi: 10.1016/s0720-048x(97)00048-x.
In wrist injury, plain radiographs form the basis of diagnostic imaging, and can provide definitive answers in most cases. MR imaging is the method of choice for several diagnostic problem cases. These problems can include radiographically occult fractures where MRI enables early diagnosis compared to follow-up radiographs. Early stage diagnosis of a post-traumatic avascular osteonecrosis with high sensitivity and specificity, is only possible with MRI. In these instances, radiographs are only sensitive in later stages and scintigraphy is quite nonspecific. Stress fractures, invisible with other modalities, are also demonstrable with MRI. In addition, MRI is helpful in special circumstances with regard to non-union or pseudarthrosis. In wrist instability, radiographs in combination with stress views and fluoroscopy are still the initial diagnostic step. MRI, with the advantage of direct visualization of the wrist ligaments and triangular fibrocartilage complex, offers very promising results in this area. Generally, for the evaluation of wrist injury, MRI can be considered the most important second-step procedure in patients where radiographs are nondiagnostic.
在腕部损伤中，普通X线片是诊断性影像学检查的基础，在大多数情况下能提供明确的诊断结果。对于一些诊断存在问题的病例，磁共振成像（MR成像）是首选方法。这些问题包括X线片隐匿性骨折，与随访X线片相比，MRI能够实现早期诊断。只有通过MRI才能对创伤后缺血性骨坏死进行高灵敏度和高特异性的早期诊断。在这些情况下，X线片仅在后期敏感，而骨闪烁显像相当不具特异性。其他检查手段无法显示的应力性骨折，MRI也能够显示。此外，在骨折不愈合或假关节的特殊情况下，MRI也有帮助。在腕关节不稳的情况下，X线片结合应力位片和荧光透视检查仍是初步诊断步骤。MRI具有直接显示腕关节韧带和三角纤维软骨复合体的优势，在这一领域提供了非常有前景的结果。一般来说，对于腕部损伤的评估，在X线片无法诊断的患者中，MRI可被视为最重要的第二步检查方法。
