磁共振成像对骨梗死的诊断价值

目的探讨磁共振成像（MRI）在骨梗死诊断中的应用价值。方法回顾性分析15例骨梗死患者的临床及MRI资料，重点分析MRI表现。结果15例骨梗死患者共发现29个病灶，单发病灶6例，两个及以上病灶9例，胫骨上段及股骨下段为其好发部位，22个病灶呈典型“地图样”改变，即MRI平扫T1WI病灶周围见地图样低信号边线，中央呈高信号，脂肪抑制T2WI病灶周围见锯齿状迂曲环形高信号边线，中央呈低信号，增强扫描病灶周同边线明显强化；3个病灶呈不规则斑片状异常信号，T1WI呈高低混杂信号，脂肪抑制T1WI呈混杂高信号，边界欠清，增强扫描呈斑片状不均匀强化；4个病灶T1WI和T2WI均呈低信号，增强扫描病灶无强化。结论MRI在骨梗死早期即可出现异常信号改变，“地图样”改变具有一定的特征，因此MRI可作为骨梗死的首选检查。

The value of magnetic resonance imaging in diagnosis of bone infarction

Objective To investigate the application value of magnetic resonance imaging in the diagnosis of bone infarction. Methods A retrospective analysis of 15 cases of bone infarction in patients with clinical and MRI data, focuses on the analysis of MRI performance. Results 15 cases of bone infarction were found in 29 lesions, 6 cases had single lesion, 9 cases with two or more lesions, the Proximal tibia and femur under paragraphs as its predilection site, 22 lesions showed typical ＂map＂ for change, namely MRI plain scan T1WI perifocal see map type low signal line, central high signal, fat suppression T2WI perifocal see jagged tortuous circular high signal line, central showed low signal intensity, enhanced scan lesions around the edge enhancement; 3 lesions showed irregular patchy abnormal signal, T1WI showed mixed signal intensity, fat suppression T2WI showed mixed high signal, borders, enhanced scan showed patchy inhomogeneous enhancement; 4 lesions of T1WI and T2WI were low signal intensity, enhanced scanning lesions are not strengthened. Conclusion MRI in early bone infarction can appear abnormal signal change, ＂map＂ for change has certain features, therefore, MRI can be used as first choice in the examination of bone infarction.