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- 文献标题：
- Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology.
- 参考中文标题：
- 意外下肢深静脉血栓形成模拟肌肉骨骼病理学。
- 文献摘要：
- OBJECTIVE: The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis. DESIGN AND PATIENTS: The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality. RESULTS: All patients showed marked reactive edema in the surrounding soft tissues or muscles. Three patients showed MR evidence of branching rim-enhancing structures within intramuscular plexuses characteristic of venous thrombosis (gastrocnemius, n=1; sural, n=2); one patient showed a distended popliteal vein. Ultrasound was able to duplicate the MRI findings in three patients: one patient showed above-the-knee extension on ultrasound; neither of the two patients with intramuscular thrombosis demonstrated on ultrasound showed extension to the deep venous trunks. CONCLUSION: Intramuscular venous thrombosis can present as marked edema-like muscle changes on MRI, simulating primary musculoskeletal conditions. In the absence of clinical suspicion for deep venous thrombosis, only the identification of rim-enhancing branching intramuscular tubular structures will allow the correct diagnosis to be made.
- 参考中文摘要：
- 目的：本研究的目的是突出的关键作用可能发挥的MRI诊断意外下肢深静脉血栓形成，并强调指出，必须审查MRI研究下肢显示显然非特异性肌肉水肿的任何证据肌内静脉血栓形成。设计与患者：影像学研究中的其中4名患者深静脉血栓形成是没有料到的临床理由，并第一次被诊断的基础上， MRI检查，审查了两个肌肉骨骼放射的共识。在所有4名患者的初步临床怀疑范围之内的肌肉骨骼损伤（腓肠肌株， 3例;破裂贝克囊肿， 1例） ，解释了选择的MRI超过超声作为第一诊断方式。结果：所有患者无明显水肿周围软组织或肌肉。 3名患者的证据显示，分支边缘增强肌肉丛结构特征的静脉血栓形成（腓肠肌， 1例;腓， 2例） ; 1例出现腹胀腘静脉。超声能够重复MRI表现3例： 1例出现上述的膝盖延长超声;既不两个病人肌肉注射血栓超声表现表明延长深静脉血栓的树干。结论：肌肉注射静脉血栓可以作为标志性水肿本类肌肉变化对核磁共振，模拟的主要肌肉骨骼条件。由于缺乏临床怀疑为深静脉血栓形成，只有确定边缘增强肌内分支的管状结构将允许正确的诊断必须作出。
- 文献作者：
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- 作者单位：
- DII - Diagnostic Imaging, Inc., Department of Radiology, Frankford Hospitals, Torresdale Campus, Red Lion and Knights Roads, Philadelphia, PA 19114, USA. aparellada@diiradiology.com
- 文献来源：
- Skeletal Radiology. 35(9):659-64, 2006 Sep.
- NLM刊名：
- Skeletal radiology 浏览此刊所有文献
- 出版国家：
- Germany
- 所用语言：
- English
- 全文链接：
- 点击查看
- 中文提供：
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- 相关链接：
- medline pubmed Google Scholar
- 国内馆藏：
（需要消耗1医币）
- 国际馆藏：
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- PMID及链接：
- 16724202 http://www.syyxw.com/Archive/Detail/16724202
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