摘要
目的:探讨Morel-Lavallée损伤(MLL)的MRI影像学特征.方法:回顾性分析2019年5月至2022年6月经手术证实为MLL的33例患者的临床及影像学资料.所有病例均行1.5T MRI扫描,MRI序列均包括至少一个扫描平面的T1WI、T2WI和质子抑脂序列.记录并分析损伤原因、损伤至MRI检查的时间,病变的位置、大小(上下径、前后径、左右径)、信号强度、是否存在假囊/结节及Mallado分型.结果:33例患者中22例受伤原因为车祸伤,7例为摔伤,2例为运动损伤,2例原因不明.患者自受伤至MRI检查时间为2～92d,平均21.5 d.病变发生部位:小腿16例,大腿5例,膝关节3例,前臂、髋关节和肘关节各2例,上臂、手腕和踝关节各1例.病灶前后径平均2.27 cm、上下径平均11.28 cm、左右径平均6.42 cm;病灶形状:椭圆形13例,圆形12例,不规则形3例,条片状5例.T1 WI序列呈低信号7例,高信号8例,混杂信号(指正在变化的信号,不高不低)13例,多种信号(低信号、高信号或混杂信号同时存在)3例;T2 WI序列呈高信号15例,混杂信号15例,多种信号3例;质子抑脂序列均呈高信号;假囊9例,结节10例.8例为Ⅰ型,6例为Ⅱ型,18例为Ⅲ型,1例为Ⅵ型.结论:MLL是闭合性皮肤软组织脱套伤,本组病例以Mallado分型1～3型为主.MRI特征性表现为皮下脂肪与深筋膜层可有不完整或完整包膜,内可伴分隔的囊袋样液性腔隙,质子抑脂序列呈高信号,病灶可呈不同形状.
Abstract
Objective:To explore the MRI imaging features of Morel-Lavallée injury(MLL).Methods:Retrospectively analyze MRI imaging data from 33 patients with MLL confirmed by surgery from May 2019 to June 2022.All cases underwent 1.5T MRI scans,and the MRI sequences included T1WI,T2WI,and proton density-weighted fat suppression sequences on at least one scanning plane.Record and analyze the cause of the injury,the time from injury to MRI examination,the location and size of the lesion(upper and lower diameter,anterior and posterior diameter,left and right diameter),signal intensity,the presence of pseudocysts or nodules,and Mallado classification.Results:Among the 33 patients,22 were injured due to car accidents,seven due to falls,two due to sports injuries,and two due to unknown causes.The time from injury to MRI examination was two and 92 days,averaging 21.5 days.Location of occurrence:16 cases in the lower leg,5 cases in the thigh,3 cases in the knee joint,2 cases in the forearm,hip joint,and elbow joint,and 1 in the upper arm,wrist,and ankle joint.The aver-age anteroposterior diameter of the lesion is 2.27cm,the average upper and lower diameters are 11.28cm,and the average left and right diameters are 6.42cm.The lesion's shape is elliptical in 13 ca-ses,circular in 12 cases,irregular in 3 cases,and strip in 5 cases.On the T1W1 sequence,there were 7 cases of low signal,8 cases of high signal,13 cases of mixed-signal(referring to changing signals,not high but not low),and 3 cases of multiple signals(referring to the presence of both low and high sig-nals or mixed signals);T2WI sequence showed 15 cases of high signal,15 cases of mixed-signal,and 3 cases of multiple signals.The proton density-weighted fat suppression sequences showed high signal intensityfor all cases.There were nine false cysts and ten nodules.Eight cases were type Ⅰ,6 were type Ⅱ,18 were type Ⅲ,and 1 was type Ⅵ.Conclusion:MLL is a closed skin and soft tissue degloving inju-ry.In this group of cases,Mallado type 13 is the main type,and MRI features are located in the subcu-taneous fat and deep fascia layers,with the formation of liquid cavities with pseudocysts or nodules.
基金项目
蚌埠医学院自然科学研究项目(2020byzd347)
阜阳市卫生健康委面上项目(FY2021-027)
安徽医科大学临床科学基金(2022xkj225)
维普
万方数据