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目的探讨糖尿病性足病的影像表现、病因及发病机制,以提高诊断水平。方法对36例经临床确诊的糖尿病性足病患者的临床资料、X线、MRI表现及有关文献进行回顾性分析。结果糖尿病足常侵犯的足骨为跖骨和近端趾骨,X线表现为骨质疏松18例,关节旁皮质骨缺损6例,骨端骨质吸收破坏15例,骨干萎缩3例,骨性关节炎2例,神经性骨关节病2例,软组织改变;6例X线平片未见明显异常。糖尿病足MRI表现:(1)软组织水肿;(2)软组织溃疡;(3)骨髓炎;(4)神经性骨关节病;(5)关节腔积液;(6)关节脱位。结论 X线平片可显示糖尿病足骨及关节较晚的骨质破坏及动脉血管钙化;MRI具有良好的软组织分辨率,可显示细微的解剖结构,能显示X线平片难以显示的早期骨髓水肿,对区分是否合并感染及感染部位、范围明显优于X线平片,具有极高的敏感性、特异性及准确性。
Objective To investigate the imaging manifestations, etiology and pathogenesis of diabetic foot disease in order to improve the diagnostic level. Methods The clinical data, X-ray findings and MRI findings of 36 clinically diagnosed diabetic foot patients were retrospectively analyzed. Results The most common violations of diabetic foot bone metatarsal and proximal phalanx, X-ray showed osteoporosis in 18 cases, 6 cases of cortical bone defects in joints, bone loss of bone in 15 cases, 3 cases of atrophy, osteoarthritis 2 cases of inflammation, 2 cases of neurogenic osteoarthritis, soft tissue changes; 6 cases of X-ray showed no obvious abnormalities. Diabetic foot MRI manifestations: (1) soft tissue edema; (2) soft tissue ulcers; (3) osteomyelitis; (4) neurogenic bone and joint disease; (5) joint effusion; Conclusion X-ray film can show the later bone destruction of bone and joint of diabetic rats and calcification of arterial vessels. MRI has good soft tissue resolution and can display subtle anatomical structure, and can show early bone marrow edema , To distinguish whether the infection and infection site, the scope is significantly superior to X-ray, with high sensitivity, specificity and accuracy.