足菌肿临床X线表现  

Clinical and radiological findings of mycetoma

作　　者：唐筱正 胡建妙 

机构地区：[1]浙江省淳安县第一人民医院放射科,311700

出　　处：《影像诊断与介入放射学》2010年第2期107-108,共2页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨足菌肿的临床X线征像,以提高对本病的认识。方法回顾分析33例经手术和病理证实的足菌肿的临床资料X线表现,并结合文献对其进行分析。结果 33例180块骨受累,其中多骨受侵27例,单骨改变6例。受累部位为跖骨(42块)、楔骨(33块)、趾骨(26块)、舟骨(10块)、骰骨(11块)、距骨(9块)、跟骨(8块)、胫骨(1块)、腕骨(22块)、掌骨(12块)、指骨(6块)。X线改变为侵蚀性骨质破坏20例,溶骨性骨质破坏6例,侵蚀性破坏伴增生硬化3例,增生硬化2例;骨干增粗和皮质增厚5例;骨膜反应6例。9例邻近骨质疏松,7例关节间隙狭窄,受累关节面模糊。2例在病灶内有条片状死骨。结论足菌肿菌病病变范围广泛,易累及多骨,也可发生在手部,骨质以侵蚀性及溶骨性破坏为主要X线表现,与慢性化脓性骨髓炎相似,但也各有其不同的特征。Objective To investigate the clinical radiologic characteristics of mycetoma. Methods Radiographs of 33 cases of Madura confirmed by surgery and pathology were retrospectively analyzed. Results Of 33 cases, multiple bones were involved in 27 and single bone in 6. A total of 180 bones were destroyed including metatarsus （42）, cuneiform （33）, phalanges of toes （26）, cuboid （11）, navicula （10）, talus （9）, calcaneus （8）, tibia （1）, carpus （22）, metacarpus （12）, phalanges of fingers （6）. X-ray changes included erosive （20） and lyric （6） destruction of bone; erosion and sclerosis （3）, sclerosis （2）; irregular diaphysis and cortical thickening （5）, periosteal reaction （6）, surrounding osteoporosis （9）, joint space narrowing （7）, with indistinct articular margins. Lamellar sequestrum was noted within 2 lesions. Conclusion Mycetoma bone infection is extensive and often involves multiple bones. The main x-ray findings are erosive and lyric destruction of bone. The radiographic appearance of the Madura foot is similar to that of chronic pyogenic osteomyelitis with some distinctions.

关 键 词：足菌肿 霉菌 骨髓炎 放射摄影术 

分 类 号：R816.8[医药卫生—放射医学] R756[医药卫生—临床医学]