MRI of scaphoid fracture.

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  • 舟状骨骨折のＭＲＩ

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An evaluation of scaphoid fractures using magnetic resonance imaging (MRI) was done. Magnetic resonance images were obtained of 5 normal wrists and 24 wrists with scaphoid fractures (9 with fresh fractures, l l with nonunion and 4 with united fractures) . All imaging was done using a General Electric Signa system operating at 1.5T with a 3-inch circular surface coil. Spin-echo pulse sequences were obtained. T1-weighted (T1W), proton density weighted (PDW) and T2-weighted (T2W) images were obtained. The coronal plane was chosen for examining the signal intensities of the scaphoid.<BR>At an early stage after scaphoid fracture, the distal fragment showed slightly low or moderate signal intensity on the T1W image and a high signal intensity area on the T2W image. High signal intensity of the distal fragment on the T2W image is diagnostic for scaphoid fracture.<BR>The proximal fragment showed low signal intensity on the T1W image and moderate signal intensity on the T2W image. In the case of nonunion, the distal fragment displayed moderate signal intensity on the T2W image. This signal intensity indicates that viability is decreased in the distal fragment. Avascular change in the proximal fragment was found in 3 out of 8 cases. When bony union of the scaphoid was complete, the distal and the proximal fragments showed moderate signal intensity on all three weighted images. Avascular change in the proximal part of the scaphoid was found in 2 out of 9 cases. MRI is very useful in making a diagnosis and judging the healing process in scaphoid fractures.

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