减压性骨坏死影像学病灶特征分析

目的探讨减压性骨坏死在CT，MRI影像中的病灶特征，包括好发部位、病灶性质、分布范围及与X线平片相比的新增部位等。方法对66名潜水工龄超过1年的潜水员进行多部位（双肩、双髋、双膝关节及附近部位）多种影像学方法（X线平片、CT及MRI）检查，并调查潜水史、既往病史和全身体格检查。结果CT，MRI检查减压性骨坏死的病灶检出率明显高于X线检查，差异有统计学意义（P〈0．05），病灶形态钙化最多，囊变其次，而X线检查中二者出现较均衡，且致密区多见；CT检查病灶发生部位除X线检查中常见部位外，还有一些新增部位出现，如骨盆、髋臼、髌骨、股骨髓腔等。结论CT，MRI检查减压性骨坏死病灶以钙化和囊变为主要形态特征，能将X线检查中部分致密区表现加以定性；新增部位病灶的临床意义尚待进一步研究。

Tomorgraphic characteristic analysis of dysbaric osteonecrosis focuses in divers

Objective To explore the tomographic characteristics of the dysbaric osteonecrosis(DON) using computed tomography(CT) and magnetic resonance imaging(MRI),including the most probable positions,focus properties,distribution areas and the additional focuses not observed in X-ray examination.Methods Examinations(X-ray,CT and MRI) of multiple positions,including both shoulders,hips,knee joints and other places,were carried out in 66 divers with more than one-year working history.All the working and diving history and previous general disease records were invstigated.At the same time,every diver underwent a whole body physical examiation.Results The incidence rate of DON in CT and MRI examiations was significantly higher than that in X-ray.CT and MRI image revealed that calcification appeared most and cyst formation second,while the appearance of the above two were equally distributed in X-ray examination,and mainly seen in dense areas.Besides the ordinary positions seen in X-ray,the extensive focus positions found in CT and MRI included pelvis,acetabulum,knee cap and marrow cavity.Conclusions Calcification and cyst formation were the main DON characteristics in CT and MRI,which can determine the nature of some dense areas in X-ray examination.More studies were needed to evaluate the clinical significance of additional focuses found in this examination.