Objective To study the magnetic resonance imaging (MR[) in patients with acute wrist injury whose X-ray was negative.Methods 155 patients treated at the department of orthopedics of our hospital from January,2012 to October,2014 were selected.Among which,85 were male and 70 female.Their average age was 28.There were two kinds of injury mechanism:low energy damage (wrist joint injury by placing wrists on floor from standing or lower height) and high energy damage (wrist joint injury caused by standing position or certain high intensity exercise).All the patients were examined by X-ray and MRI.Results 80％ female and 38％ male injured placing wrist joint on floor,with a statistical difference (P ＜ 0.05).There was no statistical difference between high and low energy damage (P ＞ 0.05).25 patients had negative MRI.The other 130 patients (83.37％) had 303 abnormal manifestations,including 54 cases of fracture,56 bone contusion,15 TFCC injury,and 5 scapholunate ligaments injury.According to the treatment strategy,most patients had received conservative treatment and achieved good results.7 patients with TFCC or SL injury needed further treatment;among which 2 patients underwent surgical treatment in order to reconstruct the TFCC ligament.Conclusions MRI should be considered as a part of early investigation,especially when the pain in the wrist joint was diagnosed in the first weeks.%目的 前瞻性研究X片阴性的急性腕关节损伤患者磁共振成像(MRI).方法 所有患者均来自于本院骨科,受试者入选时间2012年1月至2014年10月.共155例患者纳入研究,其中男85例,女70例,平均年龄28岁.受伤机制分为两类:低能量损伤(从站立或者更低的高度处摔倒手腕部撑地而损伤腕关节)和高能量损伤(人体站立位高度或者是某些高强度运动中造成的腕关节损伤).对所有患者进行标准的X片拍摄和MRI检查.结果 80％女性和38％男性在腕关节撑地后出现外伤,差异有统计学意义(P＜0.05);但高能量和低能量造成的损伤情况差异无统计学意义(P＞0.05).155例患者中,25例MRI检查阴性,其余130例(83.87％)在MRI上共有303处异常表现,包括54例骨折,56例骨挫伤,15例TFCC损伤及5例舟月韧带损伤等.按照事先拟定的治疗策略,大部分患者接受了正规保守治疗,取得了较好的效果,7例TFCC或SL损伤的患者需要手外科医生进一步处理,其中2例最后接受了手术治疗以重建撕裂的TFCC韧带.结论 MRI应被视为早期调查的一部分,尤其是当腕关节疼痛确实的前几个星期.
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