腕头月关节脱位的X线平片和CT表现

摘要

Objective To analyze imaging manifestations of dislocation of scaphoid-lunate joint, so that to improve the recognition and diagnostic ability of this disease. Methods X-ray,thin-slice multi-slice spiral CT scanning(MSCT) . multi-planar reconstruction (MPR) and volume rendering technique (VRT) findings of scaphoid-lunate joint dislocation were retrospectively analyzed, and to summarize value of different imaging methods in diagnosis. Results In 24 cases, there were 2 cases of lunate dislocation, 18 cases of dorsal perilunate dislocation without scaphoid fractures, 4 cases of transscaphoid dorsal perilunate dislocation. 4 of 24 patients combined with distal fractures of radial and ulna, 6 combined with avulsion fractures of carpus. Lunate dislocations in 2 cases, dorsal perilunate dislocation without scaphoid fractures in 16 and transscaphoid dorsal perilunate dislocation in 2 were diagnosed by X-ray. While dorsal perilunate dislocation without carpus fractures in 2 cases, trans-scaphoid dorsal perilunate dislocation in 2, avulsion fractures of carpus in 4 were misdiagnosed by X-ray. The dislocation and fractures were detected in all cases by CT. Conclusion MSCT, MPR and VRT are superior to X-ray in diagnosing the dislocation of scaphoid-lunate joint and fractures of carpus.%目的 分析头月关节脱位的X线平片和CT表现,提高对本病的认识和诊断水平.方法 回顾性分析24例头月关节脱位患者的X线平片及CT薄层扫描、多平面重组(MPR)和容积再现技术(VRT)表现,总结不同影像学检查方法的应用价值.结果 24例患者中,月骨脱位2例,月骨周围后脱位22例,其中不伴有腕舟骨骨折的单纯月骨周围后脱位18例,经舟骨月骨周围后脱位4例;合并尺桡骨远端骨折4例7处,合并腕骨撕脱性骨折6例7处.X线平片准确诊断月骨脱位2例、单纯月骨周围后脱位16例、经舟骨月骨周围后脱位2例,漏诊单纯月骨周围后脱位2例、经舟骨月骨周围后脱位1例,误诊经舟骨月骨周围后脱位1例,漏诊腕骨撕脱性骨折4例5处.CT薄层扫描结合重建技术全部准确显示脱位及骨折(100%).结论 CT薄层扫描及重建技术对显示头月关节脱位更优于X线平片.