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目的探讨糖尿病足的X线、CT和MR的影像表现及发病机制,为临床对其进行早期干预治疗提供帮助。方法对40例糖尿病足患者行X线DR检查,其中18例X线检查无明显异常或改变轻微而临床症状明显的患者同时行3.0T MR检查和宝石CT检查。结果糖尿病足最容易侵犯的是跖骨和近端趾骨,22例X线表现为16例骨质疏松,3例骨干萎缩,7例关节旁皮质骨缺损,14例骨端骨质吸收破坏,2例骨修复,2例骨性关节炎,3例神经性骨关节病,9例软组织异常。18例X线平片未见明显异常者,CT诊断结果为10例骨质疏松,5例关节面下骨质破坏其中3例伴有少量关节腔积液,13例伴有不同程度的足背、跖、趾骨间的小血管钙化;MR诊断结果为18例关节腔积液,17例周围软组织积液、水肿,7例软组织溃疡、窦道,11例局限性骨髓水肿。结论 X线平片是糖尿病足的基础检查方法,CT可以观察到更细微的异常变化,MR的软组织、早期骨髓水肿分辨率优于X线和CT,对病变部位及范围有更敏感和准确的显示。
Objective To investigate the imaging manifestations and pathogenesis of diabetic foot in X-ray, CT and MR, and to provide help for its early intervention in clinic. Methods 40 patients with diabetic foot underwent X-ray DR examination, of which 18 cases of X-ray examination showed no obvious or minor changes in patients with obvious clinical symptoms simultaneously with 3.0T MR examination and gem CT examination. Results The most susceptible cases of diabetic foot were metatarsal and proximal phalanges. Twenty-two cases of X-ray showed 16 cases of osteoporosis, 3 cases of atrophy, 7 cases of para-cortical bone defects, 14 cases of osteoporosis and 2 cases of bone- Bone repair, 2 cases of osteoarthritis, 3 cases of osteoarthritis, 9 cases of soft tissue abnormalities. 18 cases of X-ray film showed no significant abnormalities, CT diagnosis of 10 cases of osteoporosis, 5 cases of articular surface destruction of bone in 3 cases with a small amount of joint effusion, 13 cases with varying degrees of dorsal foot , Metatarsal, phalangeal calcification of small blood vessels; MR diagnostic results of 18 cases of joint effusion, 17 cases of soft tissue effusion around the edema, 7 cases of soft tissue ulceration, sinus, 11 cases of limited bone marrow edema. Conclusion X-ray film is the basic examination method of diabetic foot. CT can observe more subtle changes. The resolution of soft tissue and early bone marrow edema of MR is better than that of X-ray and CT, which is more sensitive and accurate to the lesion site and range display.