Ma L D, Frassica F J, Bluemke D A, Fishman E K
Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Crit Rev Diagn Imaging. 1997 Dec;38(6):535-68.
While the plain film and nuclear medicine bone scan are still the traditional imaging modalities used in the evaluation of musculoskeletal infection, the cross-sectional imaging modalities, computed tomography (CT) and magnetic resonance imaging (MRI), have become critical in the delineation of many types of musculoskeletal infection. In particular, the evaluation of soft tissue infections, including cellulitus, myositis, fasciitis, abscess, and septic arthritis are often best evaluated by MRI or CT due to their excellent anatomic resolution and soft tissue contrast. Even in osseous infection, CT and MRI can give better anatomic delineation of the extent of infection. In cases where the plain film and nuclear medicine bone scan findings are complicated due to previous surgery, trauma, or underlying illness, the anatomic resolution and soft tissue contrast provided by MRI and CT are often necessary to determine if underlying infection exists. MRI's visualization of the bone marrow allows for the sensitive detection of osteomyelitis, although specificity for the diagnosis of osteomyelitis is aided by other findings, including cortical destruction. The CT and MRI findings in the spectrum of musculoskeletal infections are discussed and contrasted, and pitfalls in their evaluation of musculoskeletal infection are described.
虽然X线平片和核医学骨扫描仍是评估肌肉骨骼感染的传统影像学检查方法,但断层成像方法,即计算机断层扫描(CT)和磁共振成像(MRI),在许多类型的肌肉骨骼感染的诊断中已变得至关重要。特别是对于软组织感染,包括蜂窝织炎、肌炎、筋膜炎、脓肿和化脓性关节炎,由于MRI和CT具有出色的解剖分辨率和软组织对比度,往往是最佳的评估方法。即使在骨感染中,CT和MRI也能更好地显示感染范围的解剖结构。在因既往手术、创伤或基础疾病导致X线平片和核医学骨扫描结果复杂的情况下,通常需要借助MRI和CT提供的解剖分辨率和软组织对比度来确定是否存在潜在感染。MRI对骨髓的显影有助于敏感地检测骨髓炎,不过骨髓炎诊断的特异性还需借助包括皮质破坏在内的其他表现。本文将讨论并对比肌肉骨骼感染范围内的CT和MRI表现,并描述其在肌肉骨骼感染评估中的陷阱。