Kessler S, Lingg G
Klinik und Poliklinik für Radiologie, Klinikum der Joh. Gutenberg-Universität Mainz.
Rofo. 1998 Aug;169(2):105-14. doi: 10.1055/s-2007-1015059.
Various imaging modalities are used in diagnosis of acute and chronic infectious endogenous osteomyelitis and exogenous ostitis. The pathophysiological changes of osteomyelitis/ostitis in the bone and surrounding soft tissue are known. Findings in plain film radiography show these changes only in relatively advanced stages of disease. Hence, plain film radiographs are useful as a basic imaging modality by excluding other differentials and as a follow-up modality under therapy. Ultrasound-using advanced technology--offers diagnostic help in acute osteomyelitis, especially in infants. The various techniques of nuclear medicine show much higher sensitivity for detecting osteomyelitis than plain film radiography, but do not permit good separation for bone involvement and infectious changes in the surrounding soft tissue. While computed tomography offers the ability to display bone and soft tissue separately, it has been widely replaced by magnetic resonance imaging using fat-suppressed sequences and paramagnetic contrast media which show the spread of the infectious changes with higher sensitivity and accuracy.
多种成像方式用于诊断急慢性感染性内源性骨髓炎和外源性骨炎。骨髓炎/骨炎在骨骼及周围软组织中的病理生理变化是已知的。平片X线摄影的表现仅在疾病相对晚期才显示出这些变化。因此，平片X线摄影作为一种基本的成像方式，可用于排除其他鉴别诊断，也可作为治疗期间的随访方式。利用先进技术的超声对急性骨髓炎有诊断帮助，尤其对婴儿。核医学的各种技术在检测骨髓炎方面比平片X线摄影具有更高的敏感性，但无法很好地区分骨受累情况和周围软组织的感染性变化。虽然计算机断层扫描能够分别显示骨骼和软组织，但它已被使用脂肪抑制序列和顺磁性造影剂的磁共振成像广泛取代，后者能以更高的敏感性和准确性显示感染性病变的扩散情况。
