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目的总结早期大骨节病儿童的手部MRI表现,为早期大骨节病诊断提供参考依据。方法 2009年11月-2011年12月对当地筛查出的18例6～12岁早期大骨节病患儿进行双手X线、MRI检查,并对比读片。结果所检18例大骨节病儿童的手部MRI异常主要表现为骺线不整、中断、变薄、信号改变、骺核信号改变等(29.0%)、干骺端先期钙化带与骨骺部分穿通(17.7%)等。按部位分手指近节(71.0%),中节(19.4%),远节(9.7%);干骺端为异常集中处(53.2%),其次为骨骺(46.8%),骨端无异常发现。另外MRI还能显示X线片不能显示的骺线、骺核微小形态、信号改变以及干骺端由骺板伸入指骨的中高信号影像(17.7%)等更早期的软骨病变的征象。结论 MRI较X线不仅能更清晰显示儿童大骨节病手指异常改变,而且能更早期发现更多的手指异常改变,但还需进一步随访观察。
Objective To summarize the hand MRI findings of children with Kashin-Beck disease in early stage, and to provide a reference for the diagnosis of early Kaschin-Beck disease. METHODS: From November 2009 to December 2011, 18 cases of children with early Kaschin-Beck disease, aged 6 to 12 years old, screened by X-ray and MRI were compared with each other. Results The abnormal hand MRI findings of 18 children with Kashin-Beck disease showed that epiphyseal line was abnormal, interrupted, thinned, the signal changed, epiphyseal nuclear signal changed (29.0%), metaphyseal calcification zone and epiphyseal part perforated 17.7%) and so on. According to the location, the fingers were divided into two groups: proximal section (71.0%), mid section (19.4%) and distal section (9.7%); metaphyseal site was abnormal (53.2%) followed by epiphyseal (46.8% . In addition MRI also showed that the X-ray can not show the epiphyseal line, epiphyseal micro-morphology, signal changes and the metaphysis from the epiphyseal plate into the phalanx in the high signal (17.7%) and other signs of early cartilage lesions. Conclusion Compared with X-ray, MRI can not only show the abnormal changes of finger of Kashin-Beck disease in children more clearly, but also find more abnormal changes of fingers earlier, but further follow-up observation is needed.