踝周邻关节骨囊肿的影像学诊断  

Imaging diagnosis of intra-osseous ganglia surrounding the ankle joint

作　　者：张泽坤[1] 贾晓英[2] 赵静品[1] 李玉清[1] 吴文娟[1] 

机构地区：[1]河北医科大学第三医院放射科,河北石家庄050051 [2]河北省人民医院急诊科

出　　处：《实用放射学杂志》2014年第6期979-982,共4页Journal of Practical Radiology

摘　　要：目的：探讨踝周邻关节骨囊肿影像表现特征以及其诊断价值。方法对本院1982-2012年经病理证实的40例踝周邻关节囊肿影像表现进行回顾性分析。33例行 X 线平片检查,26例行 CT 检查,13例行 MR 检查。结果单纯距骨病变23例,单纯胫骨病变15例（后踝8例,内踝6例,胫骨远端前部1例）,外踝骨囊肿1例,多发病变1例（距骨和后踝）。29例为类圆形单房状溶骨病变,11例呈多房状,内有分隔。均有轻度的硬化边,15例关节面有中断,与关节腔相通。①33例34个病灶 X 线表现为踝周骨内邻近关节面的类圆形囊样透亮区,边缘清晰、硬化,12个病灶相邻关节面可见裂隙；②26例单发病灶 CT 表现为呈圆形透亮影,边缘骨质硬化,14个病灶相邻关节面可见裂隙；③13例14个病灶 MRI 表现为 T1 WI 为低到中等信号,T2 WI 为高信号,4个病变邻近关节面骨质断裂,6例软组织肿胀。结论踝周邻关节骨囊肿的特殊发病部位结合典型影像学表现,对本病能够作出正确的影像诊断。Objective To investigate the imaging features of intra-osseous ganglia surrounding the ankle joints and their diagnostic value.Methods Imaging features of 40 cases of intra-osseous ganglia proved by the pathology from 1 982 to 2012 were analyzed retrospectively.33 cases underwent radiography,26 cases underwent computed tomography （CT）and 13 cases underwent magnetic resonance imaging （MRI）.Results Intra-osseous ganglia were detected at talus in 23 cases,distal tibia in 1 5 cases （8 cases in posterior melleolus,6 cases in medial melloulus and 1 case in anterior part of distal tibia）,and lateral malleolus in 1 case.Multiple intra-osseous ganglia was detected in 1 case,which located in both talus and posterior malleolus.29 cases were oval,monolocular osteolytic lesions.1 1 cases were multilocular lesions with separation.All cases were observed with slightly sclerous edge.Articular surface disruptions were observed in 1 5 cases,and lesions were connected with the joint space.① Oval cystic translucent areas with sharp and sclerous edge adjacent to the ankle joint were observed in 34 lesions of 33 cases on radiograph.Cracks were noted on the articular surface of 12 lesions.② Round translucent areas with sharp and sclerous edge were observed in 26 isolated lesions on CT images.Cracks were noted on the articular surface of 14 lesions.③ 14 lesions of 13 cases showed low to moderate signal on T1 WI and high signal on T2 WI.Cracks were observed in 4 lesions adjacent to the ankle joint,and soft tissue swelling was noted in 6 lesions.Conclusion Intra-osseous ganglia can be diagnosed accurately based on the typical imaging features and special locations.

关 键 词：邻关节骨囊肿 X 线摄影术 计算机体层成像 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R814.41[医药卫生—外科学]