目的:通过分析平山病的磁共振成像(MRI)表现特点和结合文献复习，提高其诊断水平。方法:报道1例经临床证实的平山病患者的MRI表现，并复习文献，探讨MRI表现的相关发病机制及病理解剖基础。结果:采用西门子Sonata 1.5T磁共振机，先取生理状态下颈椎MRI检查，显示脊髓前角非对称性萎缩和脊髓背侧硬膜外静脉丛扩张；再行屈颈状态下MRI检查，可见颈髓的硬脊膜后壁向前推移，下段颈髓局限受压变细征。结论:平山病有特征性MRI表现，结合临床、常规位和功能位屈颈状态的MRI检查，可以提示平山病。
目的 采用低场MRI非增强扫描探讨强直性脊柱炎（AS）累及脊柱的MRI表现。 方法 从2010年3月－2013年3月间就诊的76例AS患者的MRI图像中选取19例脊柱受累者资料，对病变部位MRI图像进行分析，评价AS累及脊柱在低场MRI非增强扫描状态下的MRI表现特点。 结果 19例患者中颈椎病变3例，胸椎病变9例，腰椎病变7例；MRI表现为椎体终板炎17例、椎间盘炎13例、脊柱滑膜关节炎15例、椎旁韧带炎11例、韧带骨化和骨性强直9例。 结论 低场MRI非增强扫描能直观显示AS脊柱病变，主要表现为椎体终板炎、椎间盘炎、脊柱滑膜关节炎、椎旁韧带炎、韧带骨化和骨性强直，压脂T2WI序列对活动性炎性病变显示良好，T1WI、T2WI序列能较好显示结构性病变。
【摘要】 目的 探讨0.35 T MRI各方位各序列扫描对肩袖撕裂的诊断价值。 方法 对2010年3月-2011年4月就诊的38例肩关节疼痛患者，分别在斜冠状位、斜矢状位及横轴位行T1加权像（T1 weighted image，T1WI）、T2加权像（T2 weighted image，T2WI）、质子密度加权像（proton density weighted image，PWI）及脂肪抑制像（turbo inversion recovery magnitude，TIRM）扫描。将38例患者的冈上肌及冈下肌肌腱合并为A组、肩胛下肌及小圆肌肌腱合并为B组进行研究，分别比较A、B组采用各方位的扫描表现；再将A组患者分为斜冠状位T1WI+T2WI组与斜冠状位PWI+TIRM组，将B组患者分为横轴位T1WI+T2WI组与横轴位PWI+TIRM组，分别比较各序列组的扫描表现。 结果 A组患者在3个方位扫描像以及斜冠状位T1WI+T2WI组与PWI+TIRM组之间诊断准确度差异有统计学意义（Plt;0.05），其斜冠状位诊断肩袖撕裂的灵敏度为88.9%，特异度为81.8%，准确度为86.8%，为最佳扫描方位，而PWI+TIRM组诊断肩袖撕裂的灵敏度为88.9%，特异度为90.9%，准确度为89.5%，为优选扫描序列；B组患者在3个方位扫描像以及横轴位T1WI+T2WI组与PWI+TIRM组之间诊断准确度差异有统计学意义（Plt;0.05），其横轴位诊断肩袖撕裂的灵敏度为87.5%，特异度为86.4%，准确度为86.8%，为最佳扫描方位，而PWI+TIRM组诊断肩袖撕裂的灵敏度为100%，特异度为83.3%，准确度为94.7%，为优选扫描序列。 结论 低场MRI诊断冈上肌、冈下肌肌腱撕裂以斜冠状位PWI及TIRM扫描序列为首选，诊断小圆肌、肩胛下肌肌腱撕裂则以横轴位PWI及TIRM扫描序列为主。【Abstract】 Objective To explore the clinical value of 0.35 T MRI diagnosing rotator cuff tears with different scan sequence and patient position. Methods From March 2010 to April 2011, there were 38 patients with shoulder pain were separately scanned by MRI at the position of oblique coronal, oblique sagittal and transaxial planes. Otherwise, the MRI images completed with T1 weighted, T2 weighted, PDWI and TIRM technique. The 38 cases were divided into two groups (group A: to study the supraspinatus and infraspinous tendons of the 38 cases; group B: to study the musculus teres minor and musculus subscapularis tendons of the 38 cases). Afterwards, the diagnostic results were compared among images at different patient positions. Furthermore, the images at oblique coronal plane of T1WI+T2WI and PWI+TIRM technique in group A were compared; on the other hands, the images at transaxial plane of T1WI+T2WI and PWI+TIRM technique in group B were compared. Results The difference of diagnostic accuracy in group A at different patient positions and scan sequences were statistical significant (Plt;0.05), and oblique cornal plane was the best patient position with sensitivity of 88.9%, specificity of 81.8% and accuracy of 86.8%; at the same time, the PWI+TIRM sequence was better sequence with sensitivity of 88.9%, specificity of 90.9% and accuracy of 89.5%. The difference of diagnostic accuracy in group B at different patient positions and scan sequences were statistical significant (Plt;0.05), and transaxial plane was the best patient position with sensitivity of 87.5%, specificity of 86.4% and accuracy of 86.8%; at the same time, the PWI+TIRM sequence was better sequence with sensitivity of 100%, specificity of 83.3% and accuracy of 94.7%. Conclusion In low field MRI, the oblique cornal plane with PWI+TIRM sequence are a first-line method for diagnosing supraspinatus tendon tears or infraspinous tendon tears; on the other hands, the transaxial plane with PWI+TIRM sequence are a first-line method for diagnosing musculus teres minor hurt or musculus subscapularis hurt.
Objective To explore the MRI features of juvenile-onset ankylosing spondylitis (JoAS) for improving the level of diagnosis and therapy. Methods MRI findings of JoAS in 25 patients confirmed by clinical and laboratory results between October 2010 and September 2014 were retrospectively analyzed. Results There were a total of 67 locations of lesion in the 25 cases, including 19 in sacroiliac joint, 21 in hip joint, 6 in ischial tuberosity, 6 in crista iliaca, 9 in knee joint, 4 in ankle joint, and 2 in foot. MRI showed 63 locations with bone marrow edema, 36 with joint effusion, 26 with bone destruction, and 19 with enthesitis. Conclusions Bone marrow edema is the most common MRI manifestation of JoAS, and the main bone destruction is middle axis joint. MRI is sensitive but not specific to lesions, so differential diagnosis is needed and helpful.
目的 探讨数字X线摄影（DR）的全景拼接技术在骨关节系统疾病中的临床应用价值。 方法 回顾分析2011年1月－2013年3月采用“连续多次曝光后手动软件拼接技术”及“狭缝连续拍摄自动软件拼接技术”所得的各100例（全脊柱50例，下肢全长50例）全景拼接图像，对图像质量进行评价，分析其技术特点及应用优势。 结果 两种拼接技术所得的全景拼接图像都清晰、连续、完整、质量合格，能有效满足临床诊疗需求，在质量上两者无明显差异。前者所需时间稍长，对操作者技术及经验要求较高，后者操作更显快捷方便，但设备较昂贵。 结论 DR全景拼接技术在骨关节系统疾病中有很好的普及推广应用价值，能为骨科临床提供新的更有价值的信息。