下肢局限性硬皮病的临床和磁共振表现特点  

Localized Scleroderma of Lower Extremities: Clinical and Magnetic Resonance Imaging Features

作　　者：王凤丹[1] 王宏伟[2] 吴志宏[3] 侯波[1] 姜波[1] 张燕[1] 冯逢[1] 金征宇[1] 苑勰[2] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院皮肤科,北京100730 [3]中国医学科学院北京协和医学院北京协和医院骨科,北京100730

出　　处：《中国医学科学院学报》2015年第4期392-397,共6页Acta Academiae Medicinae Sinicae

基　　金：卫生公益性行业科研专项项目(201402019)~~

摘　　要：目的探索局限性硬皮病下肢受累患者的临床特点,以及受累下肢的核磁共振成像(MRI)影像表现特点。方法回顾性分析2013年4月至2014年6月在北京协和医院接受下肢MRI检查的局限性硬皮病患者16例。收集患者的一般临床资料、抗核抗体、抗双链DNA抗体和抗可提取性核抗原抗体的实验室检查结果。核磁共振成像检查均为平扫,机器为西门子Skyra 3.0T核磁扫描仪。结果线状硬斑病11例、泛发性硬斑病4例、深在性硬斑病1例。14例患者接受抗核抗体检查,其中4例阳性(28.6%)。10例进行抗双链DNA抗体检查和7例进行抗可提取性核抗原抗体检查的结果均为阴性。最常见的MRI影像表现为皮下脂肪间隔增厚(16例)和肌肉筋膜增厚(11例),既可为T1加权成像低信号、T2快速反转恢复预脉冲/质子加权成像低信号,也可为T1加权成像低信号、T2快速反转恢复预脉冲/质子加权成像高信号。另外,还包括肌间筋膜增厚(3例)、肌肉异常信号(1例)和骨髓异常信号(2例)。结论磁共振检查能提示局限性硬皮病下肢骨骼肌肉受累的范围和程度。Objective To evaluate the clinical and musculoskeletal characteristics of localized scleroderma with lower extremities affected. Methods All the localized scleroderma patients,who received magnetic resonance（ MR） examinations of affected lower extremities at Peking Union Medical College Hospital from April2013 to June 2014, were retrospectively reviewed. Their clinical data and laboratory results of antinuclear antibody,anti-double stranded-DNA antibody, and anti-extractable nuclear antigen antibody were collected and analyzed. All the MR examinations were non-contrast imaging using Siemens Skyra 3. 0 T MR scanner.Results There were 16 localized scleroderma patients with lower extremities affected,11 of whom were linear scleroderma,4 generalized morphea,and 1 deep morphea. Female to male ratio was 1 ∶ 2. 2. The mean agewas 22. 5 years. The mean time span was 7. 4 years. Four of the 14 patients（ 28. 6 %） who received antinuclear antibody test were positive. All the 10 patients who received anti-double stranded-DNA antibody test and the 7 patients who received anti-extractable nuclear antigen antibody test were negative. The most common musculoskeletal MR features were subcutaneous septal thickening（ 16 /16） and fascial thickening（ 11 /16）.The thickened speta and fascia could either be hypointenstiy or hyperintensity on turbo inversion recovery magnitude / proton density weighted imaging. Other MR manifestations were intramuscular speta thickening（ 3 /16）, muscular abnormal signals（ 1 /16）, and bone marrow abnormal signals（ 2 /16）. Conclusion Musculoskeletal manifestations of the lower extremities with localized scleroderma can be well revealed using MR imaging.

关 键 词：局限性硬皮病 核磁共振成像 下肢 

分 类 号：R445.2[医药卫生—影像医学与核医学]