四肢外伤后骨髓水肿与隐匿性骨折的关系

The Relationship between Bone Marrow Edema and Occult Fracture after Limb Trauma

摘要: 目的：MR与三维CT联合研究外伤后骨髓水肿与隐匿性骨折的关系，以此提高对隐匿性骨折及其周围水肿的认识。方法：选取我院2018年1月~2021年8月215例外伤后平片未见骨折征象，但MR上出现骨髓水肿的患者为研究对象，通过对患者的影像学资料进行回顾性分析，观察外伤后单纯性骨髓水肿的占比；外伤后骨髓水肿中隐匿性骨折的占比；骨髓水肿的范围与隐匿性骨折线长度的关系；骨髓水肿消退时间及骨折线消失的关系。结果：215例外伤后骨髓水肿患者，外伤后仅表现为单纯骨髓水肿者有144例，占比67.0% (144/215)；骨髓水肿中有隐匿性骨折者71例，占比约为33.0% (71/215)。骨髓水肿的最大径与骨折线的长径呈正相关(r = 0.650, P < 0.01)；隐匿性骨折骨髓水肿的消失时间与骨折线的消失基本同步。结论：外伤后隐匿性骨折周围骨髓水肿的信号范围可反映隐匿性骨折的严重程度，骨髓水肿信号的消失提示隐匿性骨折的愈合。

Abstract: Objective: To study the relationship between post-traumatic bone marrow edema and occult frac-tures by combining MR and three-dimensional CT, so as to improve the understanding of occult fractures and surrounding edema. Materials and Methods: From January 2018 to August 2021, a total of 215 patients who had no signs of fracture on radiography but with bone marrow edema dis-played on MR in our hospital were selected as the research objects. Through retrospectively ana-lyzing the imaging data of the patients, we observed the proportion of simply post-traumatic bone marrow edema, the proportion of occult fracture in post-traumatic bone marrow edema, the rela-tionship between the range of bone marrow edema and the length of the occult fracture line, as well as the relationship between the regression time of bone marrow edema and the disappearance of the fracture line. Results: Of 215 patients with post-traumatic bone marrow edema, 144 cases simply showed bone marrow edema after trauma, accounting for 67.0% (144/215); 71 cases showed an occult fracture with bone marrow edema, accounting for 33.0% (71/215). The maximum diameter of bone marrow edema was positively correlated with the length and diameter of fracture line (r = 0.650, p < 0.01); the disappearance time of bone marrow edema around occult fracture line was basically synchronous with the disappearance of the fracture line. Conclusion: The signal range of bone marrow edema around post-traumatic occult fracture can reflect the severity of the occult fracture. The disappearance of the bone marrow edema signal suggests the healing of the occult fracture.