Efficacy of Magnetic Resonance Imaging in Diagnosing Osteomyelitis in Diabetic Foot Ulcers
Efficacy of Magnetic Resonance Imaging in Diagnosing Osteomyelitis in Diabetic Foot Ulcers
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DOI：
10.7547/0003-0538-104.1.24
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发表时间：
2014-01-01
影响因子：
0.7
通讯作者：
Tahara, Shinya
中科院分区：
文献类型：
--
作者：
Fujii, Miki;Terashi, Hiroto;Tahara, Shinya
背景资料：由于神经病变、血管疾病和免疫缺陷，骨髓炎的临床诊断很困难;此外，由于对足部骨髓炎的诊断没有达成共识，磁共振成像（MRI）在检测骨髓炎和区分反应性骨髓水肿方面的疗效尚不清楚。在此，我们描述了一个回顾性研究的疗效MRI的决策准确性诊断骨髓炎在diabetic foot ulcers.Methods：12糖尿病患者感染性足溃疡进行术前MRI之间的2008年1月1日，2011年12月31日。结果：MRI显示骨髓炎30例，病理证实骨髓炎30例。相反，29个部位MRI诊断的骨髓水肿在23个部位得到证实，其他6个部位显示骨髓炎。在17个切除的骨中，13个切端显示骨髓水肿，4个正常。所有的伤口愈合顺利。结论：在糖尿病足溃疡的诊断，骨髓炎往往是可靠的区别反应性骨髓水肿，除了在特殊情况下。
Background: The clinical diagnosis of osteomyelitis is difficult because of neuropathy, vascular disease, and immunodeficiency; also, with no established consensus on the diagnosis of foot osteomyelitis, the reported efficacy of magnetic resonance imaging (MRI) in detecting osteomyelitis and distinguishing it from reactive bone marrow edema is unclear. Herein, we describe a retrospective study on the efficacy of MRI for decision-making accuracy in diagnosing osteomyelitis in diabetic foot ulcers.Methods: Twelve diabetic patients with infected foot ulcers underwent preoperative MRI between January 1, 2008, and December 31, 2011. The findings were compared with the histopathologic features of 67 parts of 45 resected bones, the cut ends of which were also histopathologically evaluated.Results: Osteomyelitis was disclosed by MRI and histopathologically confirmed in 30 parts. In contrast, bone marrow edema diagnosed by MRI in 29 parts was confirmed in 23; the other six parts displayed osteomyelitis. Among 17 resected bones, 13 cut ends displayed bone marrow edema and four were normal. All of the wounds healed uneventfully.Conclusions: In the diagnosis of diabetic foot ulcers, osteomyelitis is often reliably distinguished from reactive bone marrow edema, except in special cases.