MRI对痛风性关节炎的诊断  

The diagnostic value of MRI in gouty arthritis

作　　者：陈对梅[1] 汪青山[1] 陈文静[1] 黄德干 艾雪强 张文超[1] 

机构地区：[1]广东省第二中医院放射科,广州510095

出　　处：《放射学实践》2015年第10期1040-1043,共4页Radiologic Practice

摘　　要：目的:探讨痛风性关节炎的MRI表现及其诊断价值。方法:回顾性分析经临床及病理证实的18例痛风性关节炎患者的MRI资料。结果:18例中单关节发病14例,多关节发病4例,共累及24个关节。其中第一跖趾关节8个,膝关节6个,踝关节5个,髋关节2个,肘关节2个,跗骨间关节1个。磁共振表现:滑膜增生(n=18),关节腔或滑膜囊积液(n=16),关节周围软组织肿胀(n=21),穿凿状或不规则状骨质破坏(n=14),骨髓水肿(n=6),关节间隙狭窄(n=10),关节增生(n=12);14个关节可见痛风结节,其中2个单发,12个多发;共发现痛风结节35个,T1WI呈低信号,T2WI信号强度不同,T2WI上8个病灶呈低信号,17个呈低及稍高混杂信号,10个呈稍高信号,增强后26个病灶呈不均匀强化,以边缘强化为明显,5个强化均匀,4个无强化。结论:痛风性关节炎具有多种MRI表现,MRI有利于显示痛风结节及早期病变,对痛风性关节炎的诊断具有较高的价值。Objective：To explore the MRI findings in the diagnosis of gouty arthritis.Methods：Eighteen cases of gouty arthritis proved by clinic and pathology were collected and their MRI data were reviewed.Results：Totally 24 joints with gouty arthritis existed in 18 patients,including 14 cases of single joint affected and 4cases of multi-joints involved.24 involved joints included 8first metatarsophalangeal joints,6knee joints,5ankle joints,2hip joints,2elbow joints and 1intertarsal articulations.The performances of MRI included：synovial hypertrophy in 18 joints,effusion in synovial bursa and/or articular cavity in 16 joints,swelling of periarticular soft tissue in 21 joints,punched or irregular bone destruction in 14 joints,bone marrow edema in 6joints,joint space narrowing in 10 joints and joint hypertrophy in 12 joints.There were 14 joints with 35 gouty tophi,of which 2joints had single tophus and 12 joints had multiple tophi.The signal intensity of tophi was hypointense on T1 WI,it varies on T2 WI,with hypointensity in 8joints,hypo-/slight hyper-intensity in 17 joints and slight hyperintensity in 10 joints.On postcontrast images,24 tophi showed heterogeneous enhancement,with intensive peripheral enhancement,5showed homogenous enhancement and 4no enhancement.Conclusion：Gouty arthritis has multiple performances,MRI can show gouty tophi and early changes in gout,which is useful in the diagnosis of gouty arthritis.

关 键 词：磁共振成像 关节炎 痛风性 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]