目的:通過分析平山病的磁共振成像(MRI)表現特點和結合文獻復習,提高其診斷水平。方法:報道1例經臨床證實的平山病患者的MRI表現,并復習文獻,探討MRI表現的相關發病機制及病理解剖基礎。結果:采用西門子Sonata 1.5T磁共振機,先取生理狀態下頸椎MRI檢查,顯示脊髓前角非對稱性萎縮和脊髓背側硬膜外靜脈叢擴張;再行屈頸狀態下MRI檢查,可見頸髓的硬脊膜后壁向前推移,下段頸髓局限受壓變細征。結論:平山病有特征性MRI表現,結合臨床、常規位和功能位屈頸狀態的MRI檢查,可以提示平山病。
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 探討數字X線攝影(DR)的全景拼接技術在骨關節系統疾病中的臨床應用價值。 方法 回顧分析2011年1月-2013年3月采用“連續多次曝光后手動軟件拼接技術”及“狹縫連續拍攝自動軟件拼接技術”所得的各100例(全脊柱50例,下肢全長50例)全景拼接圖像,對圖像質量進行評價,分析其技術特點及應用優勢。 結果 兩種拼接技術所得的全景拼接圖像都清晰、連續、完整、質量合格,能有效滿足臨床診療需求,在質量上兩者無明顯差異。前者所需時間稍長,對操作者技術及經驗要求較高,后者操作更顯快捷方便,但設備較昂貴。 結論 DR全景拼接技術在骨關節系統疾病中有很好的普及推廣應用價值,能為骨科臨床提供新的更有價值的信息。