CAJ | 학술논문

目的探讨减压性骨坏死的影像学表现.方法回顾性分析已确诊的4例潜水所致的减压性骨坏死影像学特征.结果该组4例减压性骨坏死病例中,病例1为Ⅰ期、病例2为Ⅱ期和病例3、4为Ⅲ期.病灶呈单骨损害1例和多骨损害3例；单侧损害1例和双侧损害3例.(1)近关节的损害:4例患者共有10个长骨的头部损害,其中肱骨头损害6个,股骨头损害4个.4例长骨的头部出现骨密度增高或硬化灶共10个,其中病例2、病例3和病例4各有1个硬化灶表现为“雪帽”征,并有7个小囊状阴影和1个累及股骨颈的大囊状阴影；病例2在CT上可见环状、线状、弯曲状和点状钙化灶；病例3、4各见1个股骨头塌陷和3个股骨头“碎裂”征,其中病例4可见2个新月征,并继发左侧髋关节骨关节炎.(2)干骺端和骨干异常:病例4平片显示右肱骨干有条状及不规则形钙化影；病例2在MPR冠状位上显示左肱骨干骺端及骨干上段条形钙化.结论长骨的头部出现骨密度增高或硬化灶,发生于多骨或呈双侧性,提示减压性骨坏死的诊断.
목적 탐토감압성골배사적영상학표현.방법 회고성분석이학진적4례잠수소치적감압성골배사영상학특정.결과 해조4례감압성골배사병례중,병례1위Ⅰ기、병례2위Ⅱ기화병례3、4위Ⅲ기.병조정단골손해1례화다골손해3례；단측손해1례화쌍측손해3례.(1)근관절적손해:4례환자공유10개장골적두부손해,기중굉골두손해6개,고골두손해4개.4례장골적두부출현골밀도증고혹경화조공10개,기중병례2、병례3화병례4각유1개경화조표현위“설모”정,병유7개소낭상음영화1개루급고골경적대낭상음영；병례2재CT상가견배상、선상、만곡상화점상개화조；병례3、4각견1개고골두탑함화3개고골두“쇄렬”정,기중병례4가견2개신월정,병계발좌측관관절골관절염.(2)간후단화골간이상:병례4평편현시우굉골간유조상급불규칙형개화영；병례2재MPR관상위상현시좌굉골간후단급골간상단조형개화.결론 장골적두부출현골밀도증고혹경화조,발생우다골혹정쌍측성,제시감압성골배사적진단.
Objective To investigate the imaging features of dybaric osteonecrosis.Methods The imaging appearances of four patients with dybaric osteonecrosis caused by diving,were analyzed retrospectively.Results In four cases with dybaric osteonecrosis including case 1 with stage Ⅰ,case 2 with stage Ⅱ,case 3 and case 4 with stage Ⅲ,there were a case with the lesion in a bone and other 3 cases with lesions in multiple bones,and a case with the lesion in unilateral bone and 3 cases with the lesions in lateral bones.( 1 ) The juxta-articular lesions:there were 10 long bones with the head lesions,including 6 humerus with the head lesions and 4 femurs with the head lesions in 4 cases.In four cases,10 sclerosis lesions appeared in the heads of long bones,each case had a "snow-capped" sclerosis lesion for case 2,case 3 and case 4.There were 7 small radiolucent lesions and a large radiolucent lesion involved in femur neck.The ringlike,linear,bending and punctuate calcification lesions were found on CT films of case 2.The osseous collapse in one femur head and the fragmentations in three femur heads could be seen in case 3 and case 4; 2 crescent signs can be seen in the bilateral femur heads of case 4 with secondary osteoarthritis in left hip joint.(2) The diaphyseal and metaphyseal lesions:the X ray film of case 4 showed the streak and irregular calcifications in the shaft of right humerus; there are strip calcifications in diaphyseal and metaphyseal of the left humerus on MPR coronal view in case 2.Conclusion The diagnosis of dysbaric osteonecrosis suggested that the increased bone density or sclerosis lesions appeared in the heads of long bones,and osteonecrosis lesions were found in multiple bones or lateral bones.