Bone Marrow Injury Of Ankle On MRI And Analysis On The Incidence And The Relevant Factors

Objective:To analyse the characteristic of MRI findings of bone marrow injuryand study the incidence of bone marrow injury related to age and gender.Materials and methods: A retrospective analysis of our hospital’s patients whowere examined ankles by MRI from February,2013to September,2013,the equipmentwas GE MR750which was the most advanced MRI at that time,87patients,97ankleswere included,the MRI sequences included sagittal T1-weighted spin echo sagitalT2-weighted spin echo sagital T2-weighted fast spin-echo images with fat saturationcoronal PD-weighted fast spin-echo images with fat saturation and axial PD-weightedfast spin-echo images with fat saturation.The bone marrow lesions of ankle are dividedinto two categories, one is calcified lesions(must be combined with CT or X-rayexamination), the other is non-calcified lesions,non-calcified lesions were divided intofour main types:(1)edema;(2)necrosis;(3)cystic;(4)hemorrha.And signal intensity of thelesion was scored semi-quantitatively with a score from0(=normal) to10(=fluid-like)in PD-weighted with fat saturation,T2-weighted with fat saturation sequences.The workof diagnose and scaling was conducted by two masters of medical imaging whoresearch in the field independently. And make sure that the results we acceptd wereconsistent,if the results were inconsistent,the decision would be made by our tutor whowas responsible for the subject in consultation. The clinical relevance of studies onpatients was reached after a thorough analysis of the data collected, and used SPSS13.0statistical software for data analysis and made the appropriate form.Results:85patients and97ankles were examined by MRI in the study,one patient underwent left ankle twice,right ankle three times MRI examinations; one patientunderwent left ankle once,right ankle3times,one patient underwent both anklestwice,one patient underwent left ankle twice,one patient underwent both ankles in oneday.The number who was diagnosed as bone marrow injury was63,number of ankleswas73,number of focus was194,the focuses distribute in the talarpulley(n=50,25.8%),talar neck(n=23,11.9%), tibial malleolus(n=18,9.3%),talarbody(n=15,7.7%).The remaining22patients25ankles had normal bone marrow,anklejoint effusion(n=10), achilles tendon injuries(n=3), synovial cyst with jointeffusion(n=1), normal subjects(n=1), clinical considerations achilles injury but withnormal MR(n=1).The number who is diagnosed as bone marrow injury was63,number of ankles was73,number of focus was194,the focuses distributed as follows:calcified lesions in threepatients four lesions(were confirmed by CT),one was in talar body, two in fibularmalleolus,two calcified lesions located at talar pussy with edema surrounded,non-calcified lesions were divided into four main types:(1)the majority was bonemarrow edema:188,the lesions were ill-defined, both high signal intensity onPD-weighted with fat saturation,T2-weighted fat saturation,low signal intensity onT1-weighted.(2) Necrosis were four,characterized by well-defined,low signal intensityon T1-weighted and high signal intensity on PD-weighted with fat saturation andT2-weighted with fat saturation images.(3) Cystic bone marrow characterized bywell-defined, round, homogeneous, with low signal intensity on T1-weighted and withpronounced hyperintensity on PD-weighted with fat saturation and T2-weighted with fatsaturation images.The cystic bone marrow changes were categorized as either withedema(n=6,on talar pully) or without edema(n=1,on calcaneal tuberosity top).(4)Hemorrhagic lesions in bone marrow(n=1),with high signal intensity on T1-weightedsequence,in T2-weighted,PD-weighted with fat saturation and T2-weighted with fatsaturation sequences were all high signal intensity, well-difined. PD-weighted with fatsaturation and T2-weighted with fat saturation sequences were the most sensitivesequences to bone marrow injury,they could detect lesions early and were capable of certainty, and part of the review of the patient after treatment of edema lesions may havevarying degrees of recovery reduced.No significant association(chi square test P values ranged between0.28and1.00)was present between gender and presence of bone marrow changes.Conclusion: Using the correct and comprehensive MRI examination sequence ofankle bone marrow can make an accurate diagnosis for early injury which can helpclinicians choose the correct and most beneficial treatment options for patients, patientswho was suspected with this disease should undergo MRI to confirm the diagnose.