痛风患者踝跗关节痛风石沉积特点的影像学分析  

Image analysis of the distribution of tophus in ankle joint and tarsal joint

作　　者：孙德政[1] 杨青[1] 胡亚彬[1] 段峰[1] 于华龙[1] 

机构地区：[1]青岛大学附属医院放射科,山东青岛266100

出　　处：《实用放射学杂志》2014年第6期969-972,986,共5页Journal of Practical Radiology

基　　金：山东省科技发展计划资助项目（2011GSF11834）.

摘　　要：目的：应用多排螺旋 CT 对踝跗关节痛风石常见沉积部位进行分析，并对痛风发病机制进行探讨研究。方法对临床确诊34例踝跗关节痛风患者的双踝跗关节行 CT 平扫检查，其中55个踝跗关节可见痛风石沉积。将痛风石沉积部位分为韧带组、肌腱组及关节组，并分别对其进行记录、分析。结果韧带组中常见受累韧带依次为距腓前韧带（n=38）、内侧韧带（距骨跟骨端）（n=30）、距跟骨间韧带（n=29）（P 〈0.05）。肌腱组最常受累肌腱为跟腱（n=18），其次为胫骨后肌腱（n=7）（P 〈0.05）。关节组依次为楔间关节（n=15）、胫腓下关节（n=10）（P 〈0.05）。结论距腓前韧带为踝跗关节痛风石最常受累韧带，跟腱为最常受累肌腱。痛风石最易累及的关节为楔骨间关节。Objective To analyze the distribution of tophus in ankle and tarsal joints by multislice spiral computed tomography （MSCT）and to explore the pathogenesis of gout.Methods 34 patients with a documented diagnosis of gout underwent CT examination of bilateral ankle and tarsal joints,and 55 ankle and tarsal joints were observed tophus.The sites of tophus deposition were categorized into groups of ligament,tendon and joint in order to record and analyze.Results The tophus were showed at the anterior talofibular ligament （n=38）,the medial ligament （the site of talus and calcaneus）（n=30）and the interosseous talocalcaneal ligament （n=29）（P 〈0.05）in the group of ligament;at achilles tendon （n= 18）,followed by tibialis posterior tendon （n= 7）（P 〈0.05）in the group of tendon;at articulations intercuneiformes （n=1 5）and inferior tibiofibular articulation （n= 10）（P 〈0.05 ）in the group of joint.Conclusion In ankle and tarsal joints,tophus is commonly deposited at the anterior talofibular ligament,at the achilles tendon and the articulationes intercuneiformes.

关 键 词：痛风 计算机体层成像 痛风石 踝跗关节 

分 类 号：R589.7[医药卫生—内分泌] R814.42[医药卫生—内科学]