CAJ | 학술논문

目的探讨MRI在单侧臀外展肌挛缩症中对诊断确定及治疗指导的作用.方法自2004年5月至2008年12月共对8例具有骨盆倾斜、肢体假性不等长, 怀疑单侧臀外展肌挛缩症的患儿进行MRI检查,其中男5例,女3例,平均年龄11岁3个月(7岁6个月至17岁2个月),骨盆向左侧倾斜6例, 向右侧倾斜2例,骨盆倾斜度平均15°(10°～18°),通过双侧肌肉对比,确定肌肉的病变位置及范围.所有确诊患儿都进行手术治疗,通过术中观察验证MRI结果的准确性.结果 MRI能够清楚显示臀部肌群的正常结构及病理改变.8例患儿的MRI均显示假性肢体增长侧臀外展肌异常改变, 其中臀中肌病变3例,臀小肌病变1例, 臀中肌和臀小肌同时受累4例.这些影像学改变主要表现为:横断面病变肌肉体积减小, 肌纤维信号低于正常,纤维结构及走行方向模糊, 肌肉间隙增宽,被脂肪组织填充.冠状面上纤维变性的肌肉在T_1和T_2相均为低信号, 表现为明显的低信号纤维条索.手术证实8例患儿均为假性肢体增长侧的臀外展肌挛缩症, 病变肌肉位置和范围与MRI所见完全一致, 术后骨盆倾斜基本恢复正常.按MRI结果寻找病变肌肉, 手术时间明显缩短、出血量减少.结论 MR检查是确诊单侧臀外展肌挛缩症的可靠方法,对手术治疗也有重要的指导意义.
목적 탐토MRI재단측둔외전기련축증중대진단학정급치료지도적작용.방법 자2004년5월지2008년12월공대8례구유골분경사、지체가성불등장, 부의단측둔외전기련축증적환인진행MRI검사,기중남5례,녀3례,평균년령11세3개월(7세6개월지17세2개월),골분향좌측경사6례, 향우측경사2례,골분경사도평균15°(10°～18°),통과쌍측기육대비,학정기육적병변위치급범위.소유학진환인도진행수술치료,통과술중관찰험증MRI결과적준학성.결과 MRI능구청초현시둔부기군적정상결구급병리개변.8례환인적MRI균현시가성지체증장측둔외전기이상개변, 기중둔중기병변3례,둔소기병변1례, 둔중기화둔소기동시수루4례.저사영상학개변주요표현위:횡단면병변기육체적감소, 기섬유신호저우정상,섬유결구급주행방향모호, 기육간극증관,피지방조직전충.관상면상섬유변성적기육재T_1화T_2상균위저신호, 표현위명현적저신호섬유조색.수술증실8례환인균위가성지체증장측적둔외전기련축증, 병변기육위치화범위여MRI소견완전일치, 술후골분경사기본회복정상.안MRI결과심조병변기육, 수술시간명현축단、출혈량감소.결론 MR검사시학진단측둔외전기련축증적가고방법,대수술치료야유중요적지도의의.
Objective To evaluate the role of magnetic resonance imaging (MRI) in diagnosing gluteal abductor contracture (GAC).Methods Eight patients, with pelvic tilt, psuudo-discrepcy in lower extremities, suspected of unilateral GAC underwent MRI before operatioa The location and extent of gluteal muscle contracture were compared to the contralateral side. Results Both normal anatomic appearance and pathological changes of gluteal muscles could be displayed by MRI. Of the 8 patients, the gluteas (gluteus medius and / or gluteus minimus) were involved on one side in MRI, glute-us medius 3 cases, gluteus minimus 1 case. and both in 4 cases. The MRI features of contracture of the gluteas included: (1) Muscle atrophy, diminished muscle volume, and lower signal intensity, fibrous structure and direction blurred, the muscle interspace widened and filled with fat.(2)Low signal intensity fibrous cord, in coronal scan the muscle invovled manifested low signal intensity fibrous cord in either T_1-weighted or T_2 -weighted images. All the changes displayed in MRI were confirmed in operations. Moreover, the operation times were shortened and blood loss lessened with pre-op MRI Conclusions MRI is effective diagnosis modality for unilateral GAC.