| 影像学检查在Muller-Weiss病诊断中的应用价值 |
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投稿时间：2020-12-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 余景武 |
YU Jing-wu |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
yu572551@163.com |
| 王晓慧 |
WANG Xiao-hui |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
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| 唐杰 |
TANG Jie |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
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| 朱小燕 |
ZHU Xiao-yan |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
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| 吴小马 |
WU Xiao-ma |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
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| 朱艺 |
ZHU Yi |
陆军第七十二集团军医院放射科, 浙江 湖州 313000 |
Department of Radiology, Army Hospital of the 72nd Army Group, Huzhou 313000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第5期，第476-480页 |
| DOI：10.12200/j.issn.1003-0034.2022.05.013 |
| 基金项目: |
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中文摘要:
目的:探讨Muller-Weiss病的影像学表现,评价影像学检查在其诊断中的应用价值。
方法:2015 年9 月至2020 年8 月收集治疗的26 例 Muller-Weiss病患者的影像学资料,其中男7例,女19例;年龄43~68(52.7±4.6) 岁。X 线检查主要观察足舟骨的形态、位置,并在负重正位X线片上测量距骨中轴线-第1跖骨中轴线的夹角(talar-first metatarsal angle,TFM),在负重侧位片上测量足弓角、距骨中轴线-第1跖骨中轴线的夹角(Meary角);CT检查主要评价足舟骨的形态、密度、邻近骨关节间隙、位置;MRI检查主要观察足舟骨的形态、信号、软骨及周围软组织改变。
结果:26 例患者单侧受累21例,双侧受累5例;X线检查主要表现为足舟骨外侧部压缩变扁,呈"逗号状"或"水滴状",舟骨向内侧移位,部分骨质碎裂,周围骨关节增生,密度高低不均,关节间隙变窄;根据患足在负重侧位X线片上的 Meary角和畸形程度进行Maceira分期,其中Ⅰ期0例,Ⅱ期2例,Ⅲ期11 例,Ⅳ期9 例,Ⅴ期4 例。CT检查,显示骨质碎裂、舟骨向内侧移位、"距楔关节"的形成等。MRI检查主要表现为足舟骨形态不规则、信号不均,关节间隙变窄,距舟关节面增生、软骨破坏,跗骨关节积液,周围软组织肿胀。
结论:Muller-Weiss病具有较特异的影像学表现,结合患者年龄、性别、临床病史可作出准确诊断;术前影像学检查可对疾病进行分期,帮助临床医生制定更好的手术方案,术后影像学检查能较好评价手术效果。 |
| 【关键词】Muller-Weiss病 骨坏死 X线摄影术 |
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| Application value of imaging examination in the diagnosis of Muller-Weiss disease |
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ABSTRACT
Objective: To analyze radiological characteristics of Muller-Weiss disease,evaluate the clinical value of the imaging examination in diagnosis of Muller-Weiss disease.
Methods: The imaging data of 26 patients with Muller-Weiss disease were collected from September 2015 to August 2020,including 7 males and 19 females,aged 43 to 68 years old with an average of (52.7±4.6) years old. In the X-ray examination observed the shape and position of the navicular bone. The talar-first metatarsal angle(TFM) was measured on the weight-bearing anteroposterior radiograph. The arch angle and angle between mid-axis of talus and mid-axis of the first metatarsal(Meary angle) were measured on the weight-bearing lateral radiographs. The morphology,density,adjacent joint space and position of the navicular bone were evaluated by computed tomography(CT),and magnetic resonance imaging(MRI) was used to observe the shape,signal,cartilage and surrounding soft tissue changes of the navicular bone.
Results: Among 26 patients,21 cases were unilateral and 5 cases were bilateral;X-ray examination showed that the lateral part of navicular bone of foot was compressed and flattened,showing"comma like"or"drop like",navicular moved to the medial side,partial fragmentation of bone,peripheral articular hyperplasia,uneven density and narrowing of relationship gap. According to Meary angle and deformity degree of the affected foot on the lateral X-ray of the load-bearing foot,Maceira staging was performed. There were 0 cases in stageⅠ,2 cases in stage Ⅱ,11 cases in stage Ⅲ,9 cases in stage Ⅳand 4 cases in stage Ⅴ. CT examination showed bone fragmentation,medial displacement of navicular bone and formation of the talocalcaneal joint. MRI examination showed the irregular shape and uneven signal of navicular bone,narrowing of joint space,talocalcaneal joint surface hyperplasia and cartilage destruction,tarsal joint effusion and swelling of surrounding soft tissue.
Conclusion: Muller-Weiss disease has specific imaging manifestation,and an accurate diagnosis can be made based on the patient's age,gender,and clinincal history. Preoperative imaging examination can stage the disease,help clinicians to formulate better surgical plans,and postoperative imaging examination can better evaluate the surgical effect. |
| KEY WORDS Muller-Weiss disease Osteonecrosis Radiography |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 余景武,王晓慧,唐杰,朱小燕,吴小马,朱艺.影像学检查在Muller-Weiss病诊断中的应用价值[J].中国骨伤,2022,35(5):476~480 |
| 英文格式: | YU Jing-wu,WANG Xiao-hui,TANG Jie,ZHU Xiao-yan,WU Xiao-ma,ZHU Yi.Application value of imaging examination in the diagnosis of Muller-Weiss disease[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(5):476~480 |
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