关节滑膜结核的MRI表现及其诊断优势  

MRI Features and Diagnosis Advantages of Synovial Tuberculosis in Joints

作　　者：李江红[1] 孙莉[1] 刘艳[1] 杨进军[1] 梅合利[1] 冯伯荘 

机构地区：[1]新疆医科大学第五附属医院影像科,乌鲁木齐830011

出　　处：《临床放射学杂志》2009年第8期1122-1125,共4页Journal of Clinical Radiology

摘　　要：目的探讨MRI在早期关节滑膜结核诊断中的优势。资料与方法回顾分析13例经手术病理证实的关节滑膜结核的MR表现。13例均行X线正侧位摄片及MRI平扫,其中7例行MR增强扫描,5例行CT平扫。结果13例病变关节均表现为滑膜不同程度肿胀、增厚,其中7例增生滑膜呈结节状、团块状,增厚的滑膜在T1WI上呈低信号,在T2WI上大部分呈不均匀高信号,个别呈中等偏低信号;8例T2WI显示增厚的滑膜内散布小片状及囊状高信号,T1WI上呈稍低信号。关节软骨T1WI信号减低,无明显形态改变5例,变薄、毛糙4例,部分或大部分破坏消失4例。关节边缘囊状或小圆形骨质破坏6例,关节骨端骨髓水肿9例,其中3例为骨端大范围水肿并向骨干蔓延。关节内及关节周围积液13例。7例增强扫描均见增厚的滑膜呈不同程度强化,其中5例于增厚的滑膜内可见多发环形或不规则环形强化。结论MRI可全面反映滑膜结核的病理改变,对其诊断及鉴别诊断具有重要价值。Objective To analyze the MRI findings of synovial tuberculosis, and to evaluate the MRI advantages in diagnosis. Materials and Methods 13 cases of synovial tuberculosis confilrmed by surgery and pathology were studied retro spectively. 13 cases were thoroughly examined by X-ray and MRI ,in which 7 cases were examined by enhanced MR Scarming and 5 cases were checked by CT scanning. Results MR performance in all 13 patients joints showed synovial swelling and hyperplasia in different degrees, in which 7 cases hyperplasia synovial was demonstrated as massive and nodular shapes, all hyperplasia synovial membrane showed a low signal on the Tl WI, majority of them showed an in-homogenous high signal on T2WI ,rare cases showed middle-low signal. T2WI showed scattered small pieces and cystic high signal in 8 cases ,where T1WI showed a slightly low signal. T1 WI signal decreased at articular cartilage and 5 cases had no significant morphological changes ,4 cases with thinning and rough surface,4 cases with partial or major damage, destroy and disappeared. Joints edge with cystic or small round shape damage 6 cases,9 cases had bone marrow edema at joint bone end where 3 eases had a large scale edema from bone end and spreads to diaphysis. 13 cases had intra/extral-joint effusion. 7 cases showed different degrees of synovial membrane hyperplasia and strengthening in enhanced seanning in which 5 eases with multiple ring shape or or irregular ring shape strengthening. Conclusion MRI can comprehensively reflect pathological changes of the synovial tuberculosis, superior to X-ray and CT, and has its great value in early diagnosis of synovial tuberculosis.

关 键 词：结核 骨关节 磁共振成像 

分 类 号：R529.2[医药卫生—内科学] R445.2[医药卫生—临床医学]