关键词：月骨；骨坏死；磁共振成像；尺骨；变异(遗传学)
【摘要】目的 分析尺骨撞击综合征引发的月骨和三角骨缺血性坏死的MRI表现，以确定其影像学特征。方法 对23例尺侧腕痛病例行X线测量及MRI检查。结果 尺骨阳性变异范围在1～3.8mm，平均2.1 mm。阴性变异范围0.5～2.2 mm，平均1.8 mm。尺骨阳性变异13例，伴月骨和三角骨坏死9例；阴性变异6例，伴月骨坏死2例；中性变异4例，伴月骨和三角骨坏死2例。MRI示坏死区位于月骨尺侧部分近端和三角骨腰部。病变早期骨髓呈水肿性改变，随后呈透镜样改变，晚期呈不典型“双线”或“双环”征。结论 尺骨撞击综合征常引发月骨尺侧部分近端和三角骨腰部缺血性坏死，MRI可显示其早期改变。
MRI findings of ulnar impaction syndrome
HAN Yue，LIAN Zongcheng，LIU Zhiqiang
(Department of Radiology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)
【Abstract】Objective To investigate the characteristic MR features of avascular necrosis of the lunate and the triquetrum complicated with ulnar impaction syndrome.Methods X-ray measurement and MRI examination were performed in 23 patients with ulnar side wrist pain.Results The range of ulnar variance was 1.0 to 3.8 mm and the average ulnar variance was 2.1 mm.The range of positive ulnar variance was 0.5 to 2.2 mm,an average of 1.8 mm.Positive variance was found in 13 cases,and of them 9 cases were complicated with avascular necrosis of ulnar and triquetrum.Of the 6 cases with negative ulnar variance,2 cases had avascular necrosis of the lunate.Of the 4 cases with neutral ulnar variance,avascular necrosis of the ulnate and the triquetrum was presented in 2 cases.Necrosis of the lunate was presented on the ulnar side of the proximal end of the lunate and waist of triquetrum .In the early stage,edema of bone marrow was presented and was followed by a bright lentiform signal on T2 WI.The atypical “double line” or “ double-ring” sign was displayed later.Conclusion Avascular necrosis of the lunate and the triquetrum was complicated with ulnar impaction syndrome.The location of the necrosis on the ulnar side of the proximal end of the lunate as well as the triquetrum is characteristic in diagnosis.MRI can show the early changes of avascular necrosis.
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