[1]黄珍欢,鲜于志群,陈飞,等.急性骨髓炎的影像学诊断研究进展[J].国际放射医学核医学杂志,2011,35(5):264-268.[doi:10.3760/cma.j.issn.1673-4114.2011.05.003]
　HUANG Zhen-huan,XIANYU Zhi-qun,CHEN Fei,et al.Progress of imaging research on the early diagnosis of acute osteomyelitis[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(5):264-268.[doi:10.3760/cma.j.issn.1673-4114.2011.05.003]
点击复制

急性骨髓炎的影像学诊断研究进展(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
35
期数:
2011年第5期
页码:
264-268
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
Progress of imaging research on the early diagnosis of acute osteomyelitis
作者:
黄珍欢;  鲜于志群;  陈飞;  陈璟
华中科技大学附属同济医院核医学科, 武汉 430030
Author(s):
HUANG Zhen-huan;  XIANYU Zhi-qun;  CHEN Fei;  CHEN Jing
Department of Nuclear Medicine, the Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430030, China
关键词:
骨髓炎; 放射摄影术; 超声检查; 体层摄影术; X线计算机; 磁共振成像; 放射性核素显像
Keywords:
Osteomyelitis; Radiography; Ultrasonography; Tomography; X-ray computed; Magnetic resonance imaging; Radionuclide imaging
DOI:
10.3760/cma.j.issn.1673-4114.2011.05.003
摘要:
急性骨髓炎的影像学诊断技术包括X线平片、超声、CT、MRI及放射性核素显像。早期X线平片的诊断灵敏度低。超声能早期发现深部软组织及骨膜下脓肿,但图像质量取决于操作者的熟练程度。CT能早期观察到微小的骨质改变,但灵敏度较低。MRI可优于其他检查显示髓腔内的病变,但对于死骨、钙化的诊断不如CT灵敏。放射性核素显像剂的种类繁多,灵敏度和特异度各不相同。该文对急性骨髓炎的上述影像学诊断技术进行综述。
Abstract:
The imaging diagnostic techniques include X-ray plain film, ultrasound, CT, MRI and radionuclide imaging. X-ray plain film is less sensitive to early acute osteomyelitis. Ultrasound can detect abscesses in the soft tissues and subperiosteal space earlier, but there are variations in image quality based on the different operators’ levels of proficiency. High-resolution CT can find minimal lesions on bone, but it has a low sensitivity to predict acute osteomyelitis. MRI is superior to other imaging techniques at visualizing bone marrow lesions, but it is less sensitive in detecting sequestrum and calcification than CT. A variety of radionuclide imaging agents have been used in the early diagnosis of acute osteomyelitis in order to find a more sensitive and specific imaging technique. In this paper, different imaging diagnostic techniques of acute osteomyelitis are reviewed.

参考文献/References:

[1] Pineda C,Espinosa R,Pena A.Radiographic imaging in osteomyelitis:the role of plain radiography,computed tomography,ultrasonography,magnetic resonance imaging,and scintigraphy.Semin Plast Surg,2009,23(2):80-89.
[2] 徐璐杰,张德文.儿童急性骨髓炎的早期影像学检查.临床小儿外科杂志,2006,5(3):231-233.
[3] 高岩,翁磊,袁珍,等.小儿急性骨髓炎超声诊断和X-线、CT对照分析.中国超声医学杂志,2005,21(9):709-711.
[4] 白荣杰,程晓光,顾翔,等.不典型骨髓炎的X线、CT和MR影像比较分析.中国临床医学影像杂志,2008,19(7):488492.
[5] Malcius D,Jonkus M,Kuprionis G,et al.The accuracy of different imaging techniques in diagnosis of acute hematogenous osteomyelitis.Medicina(Kaunas),2009,45(8):624-631.
[6] 邱国华,梁飞虎,李耀平,等.CT诊断急性骨髓炎的价值.现代医院,2005,5(10):20-21
[7] Fayad LM,Carrino JA,Fishman EK.Musculoskeletal infection:role of CT in the emergency department.Radiographics,2007,27(6):1723-1736.
[8] Schlesinger AE,Hernandez RJ.Diseases of the musculoskeletal system in children:imaging with CT,sonography,and MR.AJR Am J Roentgenol,1992,158(4):729-741.
[9] 王益民,李峥,刘利君.B超早期诊断小儿急性骨髓炎.山西医药杂志,2002,31(1):48-49.
[10] 高岩,袁珍.超声检查及彩色多普勒血流显像技术对小儿急性骨髓炎的诊断价值.中国超声医学杂志,1998,14(5):23-24.
[11] Mah ET,Le Quesne GW,Gent RJ,et al.Ultrasonic features of a cute osteomyelitis in children.J Bone Joint Surg Br,1994,76(6):969-974.
[12] Howard CB,Einhom M,Dagan R,et al.Ultrasound in diagnosis and management of acute haematogenous osteomyelitis in children.J Bone Joint Surg Br,1993,75(1):79-82.
[13] Benson CB.Sonography of the musculoskeletal system.Rheum Dis Clin North Am,1991,17(3):487-504.
[14] 龚光文.MRI诊断急性化脓性骨髓炎的探讨.现代医用影像学,2008,17(2):65-67.
[15] 何涌,钟鸣.MRI诊断平片阴性的急性骨髓炎.华夏医学,2008,21(3):511-512.
[16] 蒋海清,钟俊远.MRI在急性骨髓炎早期诊断中的临床应用.中国临床医生,2007,35(4):66-67.
[17] Averill LW,Hernandez A,Gonzalez L,et al.Diagnosis of osteomyelitis in children:utility of fat-suppressed contrast-enhanced MRI.AJR Am J Roentgenol,2009,192(5):1232-1238.
[18] Wardak E,Gill S,Wardak M,et al.Role of MRI in detecting early physeal changes due to acute osteoarticular infection around the knee joint:a pilot study.Int Orthop,2009,33(6):1707-1711.
[19] 明江华,陈喜兰,张驽,等.MRI对儿童急性化脓性骨髓炎的早期诊断和治疗的指导价值.实用放射学杂志,2004,20(6):525-527.
[20] 陈喜兰,江桂华,田军章,等.急性化脓性骨髓炎的MRI表现.中华放射学杂志,2001,35(7):533-535.
[21] MeAndrew PT,Clark C.MRI is best technique for imaging acute osteomyelitis.BMJ,1998,316(7125):147.
[22] Riise OR,Kirkhus E,Handeland KS,et al.Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study.BMC Pediatr,2008,8(1):45.
[23] Unger E,Moldofsky P,Gatenby R,et al.Diagnosis of osteomyelitis by MR imaging.AJR Am J Roentgenol,1988,150(3):605-610.
[24] Bonhoeffer J,Haeberle B,Schaad UB,et al.Diagnosis of acute haematogenous osteomyelitis and septic arthritis:20 years experience at the University Children’s Hospital Basel.Swiss Med Wkly,2001,131(39-40):575-581.
[25] Connolly LP,Connolly SA,Drubach LA,et al.Acute hematogenous osteomyelitis of children:assessment of skeletal scintigraphy-based diagnosis in the era of MRI.J Nucl Med,2002,43(10):1310-1316.
[26] Connolly SA,Connolly LP,Drubach LA,et al.MRI for detection of abscess in acute osteomyelitis of the pelvis in children.AJR Am J Roentgenol,2007,189(4):867-872.
[27] Tuson CE,Hoffman EB,Mann MD.Isotope bone scanning for acute osteomyelitis and septic arthritis in children.J Bone Joint Surg Br,1994,76(2):306-310.
[28] Seldin DW,Heiken JP,Feldman F,et al.Effect of soft-tissue pathology on detection of pedal osteomyelitis in diabetics.J Nucl Med,1985,26(9):988-993.
[29] Alazraki N,Dries D,Datz F,et al.Value of a 24-hour image(four-phase bone scan) in assessing osteomyelitis in patients with peripheral vascular disease.J Nucl Med,1985,26(7):711-717.
[30] Teates CD,Williamson BR."Hot and cold" bone lesion in acute osteomyelitis.AJR Am J Roentgenol,1977,129(3):517-518.
[31] Schauwecker DS,Burt RW,Park HM,et al.Comparison of purified indium-111 granulocytes and indium-111 mixed leukocytes for imaging of infections.J Nucl Med,1988,29(1):23-25.
[32] McDougall IR,Baumert JE,Lantieri RL.Evaluation of 111In leukocyte whole body scanning.AJR Am J Roentgenol,1979,133(5):849-854.
[33] Raptopoulos V,Doherty PW,Goss TP,et al.Acute osteomyelitis:advantage of white cell scans in early detection.AJR Am J Roentgenol,1982,139(6):1077-1082.
[34] 彭阿钦,潘进社,吴希瑞,等.应用骨扫描早期诊断儿童急性骨髓炎新进展.中国矫形外科杂志,1997,4(6):512-513.
[35] Crymes WB Jr,Demos H,Gordon L.Detection of musculoskeletal infection with 18F-FDG PET:review of the current literature.J Nucl Med Technol,2004,32(1):12-15.
[36] Stumpe KD,Strobel K.18F FDG-PET imaging in musculoskeletal infection.Q J Nucl Med Mol Imaging,2006,50(2):131-142.
[37] Koort JK,Mäkinen TJ,Knuuti J,et al.Comparative 18F-FDG PET of experimental Staphylococcus aureus osteomyelitis and normal bone healing.J Nucl Med,2004,45(8):1406-1411.
[38] Awasthi V,Goins B,Klipper R,et al.Imaging experimental osteo-myelitis using radiolabeled liposomes.J Nucl Med,1998,39(6):1089-1094.
[39] Flivik G,Sloth M,Rydholm U,et al.Technetium-99m-nanocolloid scintigraphy in orthopedic infections:a comparison with indium-111-labeled leukocytes.J Nucl Med,1993,34(10):1646-1650.
[40] Gratz S,Rennen HJ,Boerman OC,et al.99mTc-interleukin-8 for imaging acute osteomyelitis.J Nucl Med,2001,42(8):1257-1264.
[41] Singh B,Mittal BR,Bhattacharya A,et al.Technetium-99m ciprofloxacin imaging in the diagnosis of postsurgical bony infection and evaluation of the response to antibiotic therapy:A case report.J Orthop Surg(Hong Kong),2005,13(2):190-194.

相似文献/References:

[1]陈超坤,刘亮,傅飞先,等.囊性胸腺瘤和囊性畸胎瘤的影像学特征及鉴别诊断[J].国际放射医学核医学杂志,2016,40(1):31.[doi:10.3760/cma.j.issn.1673-4114.2016.01.007]
　Chen Chaokun,Liu Liang,Fu Feixian,et al.Imaging features and differential diagnosis of cystic thymoma and cystic teratoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(5):31.[doi:10.3760/cma.j.issn.1673-4114.2016.01.007]
[2]廖光星,冷志欣,肖国有.前列腺癌骨转移影像诊断方法研究进展[J].国际放射医学核医学杂志,2016,40(6):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
　Liao Guangxing,Leng Zhixin,Xiao Guoyou.Progress of imaging in the diagnosis of bone metastases of prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(5):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
[3]刘良卿,郑建刚,杨克宇,等.急性氯气中毒患者胸部影像学表现分析[J].国际放射医学核医学杂志,2012,36(2):124.[doi:10.3760/cma.j.issn.1673-4114.2012.02.017]
　LIU Liang-qing,ZHENG Jian-gang,YANG Ke-yu,et al.Analysis of chest image performance in patients with acute chlorine poisoning[J].International Journal of Radiation Medicine and Nuclear Medicine,2012,36(5):124.[doi:10.3760/cma.j.issn.1673-4114.2012.02.017]
[4]孟庆玉.影像学检查在急性非缺血性胸痛诊断中的临床价值[J].国际放射医学核医学杂志,2012,36(2):127.[doi:10.3760/cma.j.issn.1673-4114.2012.02.018]
[5]孟钺.68例老年肺结核X线及CT征象分析[J].国际放射医学核医学杂志,2010,34(1):58.[doi:10.3760/cma.j.issn.1673-4114.2010.01.016]
[6]程志宏.小儿支原体肺炎胸部X线分析[J].国际放射医学核医学杂志,2010,34(1):63.[doi:10.3760/cma.j.issn.1673-4114.2010.01.019]
[7]孔令海,张良安,姜恩海,等.心血管病介入操作时患者受照剂量估算[J].国际放射医学核医学杂志,2010,34(3):183.
　KONG Ling-hai,ZHANG Liang-an,JIANG En-hai,et al.Estimating the radiation dose of patient in cardiovascular disease interventional procedures[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(5):183.
[8]董华,张遵城,郭永涛,等.99Tcm-聚合白蛋白肺灌注显像对肺栓塞溶栓疗效的评价[J].国际放射医学核医学杂志,2009,33(2):76.[doi:10.3760/cma.j.issn.1673-4114.2009.02.004]
　DONG Hua,ZHANG Zun-cheng,GUO Yong-tao,et al.Evaluation of 99Tcm-macroaggregated albumin pulmonary perfusion imaging to thrombolytic therapy in pulmonary embolism[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(5):76.[doi:10.3760/cma.j.issn.1673-4114.2009.02.004]
[9]邱新峰,刘强.鼻咽癌放疗致放射性脑损伤的临床分析[J].国际放射医学核医学杂志,2008,32(3):191.
[10]汪俊剑.影像学结合纤维支气管镜检查右中叶肺不张的结果分析[J].国际放射医学核医学杂志,2008,32(3):192.

备注/Memo

备注/Memo:
收稿日期:2011-06-13。
通讯作者:陈環(Email:lindaxcx@hotmail.com)
更新日期/Last Update: 1900-01-01