关节米粒体滑囊炎MRI影像征象分析  

MRI Features of Joint Bursitis with Rice Bodies

作　　者：吴梦楠[1] 王若凝 黄志明[1] 任明达[3] 吴文秀 WU Meng-nan;WANG Ruo-ning;HUANG Zhi-ming;REN Ming-da;WU Wen-xiu(Department of Radiology,the Affiliated Heyuan Hospital of Jinan University,Heyuan 517000,China;Department of Minimally Invasive and Interventional Surgery,Tumor Hospital of Sun Yat-Sen University,Guangzhou 510060,China;Department of Radiology,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China;Department of Radiology,Foshan First People’s Hospital Affiliated to Sun Yat-Sen University,Foshan 528000,China)

机构地区：[1]暨南大学附属河源医院放射科,广东河源517000 [2]中山大学肿瘤医院微创与介入科,广州510060 [3]中山市中医院放射科,广东中山528400 [4]中山大学附属佛山第一人民医院放射科,广东佛山528000

出　　处：《南昌大学学报（医学版）》2020年第3期78-80,84,F0003,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的分析关节米粒体滑囊炎MRI影像特点及诊断要点。方法回顾性分析病理证实的6例7个关节米粒体滑囊炎的临床及影像资料(肩关节4例,腕关节2例),与病理对照,并结合文献复习。结果6例患者中4例为类风湿性关节滑囊炎,1例为结核性关节滑囊炎,1例为慢性关节滑囊炎。6例均行MRI平扫,其中2例肩关节及1例腕关节进行增强扫描。MRI显示,关节米粒体滑囊炎中典型表现为米粒体,米粒体分布不均,大小不一,形态呈米粒状、芝麻状,在T1WI呈低信号,2例米粒体形态、边缘清楚,T2WI呈等低信号,形态、边缘清楚,DWI和ADC图均呈低信号;2例肩关节及1例腕关节行增强扫描示,增厚滑囊明显强化,米粒体无强化;7个关节邻近骨质都有不同程度骨侵蚀。结论MRI在形态、大小、信号、边缘、强化上明显体现了米粒体的典型特征,有助于提高关节米粒体滑囊炎的诊断率。Objective To analyze the MRI characteristics and diagnosis of joint bursitis with rice bodies.Methods Clinical and imaging data of 6 patients with pathologically confirmed bursitis with rice bodies in 7 joints(4 cases of shoulder joint bursitis and 2 cases of wrist joint bursitis)were retrospectively analyzed and compared with pathologic findings.Furthermore,the related literature was reviewed.Results Of the 6 patients,4 had rheumatoid bursitis,1 was tuberculous bursitis,and 1 had chronic bursitis.MRI scan was performed in all patients.Among them,2 patients with shoulder joint bursitis and 1 patient with wrist joint bursitis underwent contrast-enhanced scan.The MRI revealed typical bursitis with unevenly distributed and differently sized rice-or sesame-like bodies,which showed low signal intensity on T1WI.In 2 cases,rice bodies had clear shape and margin,and caused low signal intensity on T2WI and DWI and ADC maps.Contrast-enhanced scan indicated that the thickened bursa was obviously enhanced,but the rice bodies were not.Different degrees of adjacent bone erosion were found in all the 7 joints.Conclusion MRI can show typical characteristics of rice bodies in shape,size,signal,edge and enhancement,which are helpful to improve the diagnosis of joint bursitis with rice bodies.

关 键 词：米粒体滑囊炎 关节 MRI 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684.3[医药卫生—诊断学]