标题：X线平片及3.0T磁共振对膝关节自发性骨坏死的诊断价值

      作者：邓冠华，曾仲刚，王俊    东莞市中医医院医学影像科，广东 东莞 523000

      卷次： 2020年31卷8期

      【摘要】 目的 探究3.0T磁共振(MRI)诊断膝关节自发性骨坏死(SONK)的临床价值。方法 前瞻性选取东莞市中医医院医学影像科在2016年7月至2019年7月期间收治的60例膝关节自发性骨坏死患者作为研究对象。所有患者均依次行膝关节X线、3.0T磁共振扫描成像检查，并经病理检查确诊，对两种检查方式的诊断结果进行对比分析。结果 X线平片扫描检查结果显示膝关节病灶20个，40个无病灶膝关节，诊断准确率为33.33%，X线显示病灶膝关节股骨髁或胫骨平台变平、塌陷，关节面下骨质裂隙征，伴周围骨质硬化；膝关节自发性骨坏死的MRI诊断信号特征显示T1WI呈低信号，T2WI为呈“骨折裂隙”征象等或混杂信号，伴骨髓水肿，采用MRI检查结果显示病灶膝关节 60个，诊断准确率为 100.00%，MRI诊断准确率明显高于X线平片检查，差异具有显著统计学意义(P<0.01)。结论 3.0T磁共振检查膝关节自发性骨坏死较X线具有较高的准确性，能够为临床诊断和治疗提供更加精细的信息，是一种理想的影像学检查方法。
      【关键词】 磁共振成像；膝关节；自发性骨坏死；X线；临床诊断
      【中图分类号】 R681 【文献标识码】 A 【文章编号】 1003—6350（2020）08—1025—04

Diagnostic value of 3.0 T magnetic resonance for spontaneous osteonecrosis of knee joint.
DENG Guan-hua, ZENGZhong-gang, WANG Jun. Department of Medical Imaging, Dongguan Hospital of Traditional Chinese Medicine, Dongguan523000, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical value of 3.0 T magnetic resonance (MRI) in the diagnosis ofspontaneous osteonecrosis of the knee (SONK). Methods Sixty patients with spontaneous osteonecrosis of the knee,who admitted to Department of Medical Imaging of Dongguan Traditional Chinese Medicine Hospital from July 2016 toJuly 2019 were selected prospectively. All patients underwent knee X-ray and 3.0 T magnetic resonance scanning imag-ing examination, and confirmed by pathological examination. The diagnosis results of the two examination methods wascompared and analyzed. Results X-ray plain film examination showed 20 knee joints and 40 non-lesion knee joints,and the diagnostic accuracy rate was 33.33%. X-rays showed that the knee joint femoral condyle or tibial plateau flat-tened and collapsed, and the bone below the joint surface had fissure sign with surrounding sclerosis; the MRI diagnosticsignal features of spontaneous osteonecrosis of the knee showed low signal on T1WI, "fracture and fissure" signs ormixed signals with bone marrow edema on T2WI. MRI examination showed 60 lesions of the knee joint, and the diag-nostic accuracy was 100.00%, which was significantly higher than that of plain radiographs (P<0.01). Conclusion In thediagnosis of spontaneous osteonecrosis of the knee joint, 3.0 T magnetic resonance has higher accuracy than X-ray, whichcan provide more detailed information for clinical diagnosis and treatment, and is an ideal imaging examination method.
      【Key words】 Magnetic resonance imaging (MRI); Knee joint; Spontaneous osteonecrosis; X-ray; Clinical diagnosis