MRI与超声诊断长期血液透析患者透析相关性淀粉样变价值分析  

Diagnostic Value of MRI and Ultrasound for Dialysis-Related Amyloidosis in Patients Undergoing Long-Term Hemodialysis

作　　者：刘倩[1] 鲁华[1] 蒲萌萌 杨凯 李娜[2] LIU Qian;LU Hua;PU Meng-meng;YANG Kai;LI Na(Department of Nephrology,Xingtai People's Hospital,Xingtai 054001,Hebei Province,China;Department of Obstetrics,Xingtai People's Hospital,Xingtai 054001,Hebei Province,China)

机构地区：[1]邢台市人民医院肾内科,河北邢台054001 [2]邢台市人民医院产科,河北邢台054001

出　　处：《中国CT和MRI杂志》2021年第11期186-188,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振成像(MRI)与超声诊断长期血液透析患者透析相关性淀粉样变(DRA)的价值。方法回顾性分析我院2013年10月至2018年12月期间收治的60例长期血液透析伴有DRA患者的临床病历资料和影像学资料。结果超声诊断DRA 51例(85.00%),MRI诊断DRA 49例(81.67%),两组比较无明显差异(P>0.05)。B超诊断51例DRA可见关节腔内小斑片强回声或骨关节轻度增厚,均未见骨质异常改变;MRI诊断49例DRA中关节滑膜增厚49例,关节软骨侵蚀49例(其中16例伴软骨下骨质吸收),囊样骨质破坏35例,肌腱及韧带损伤28例,骨质疏松23例,关节肿胀20例(其中7例合并关节腔积液),骨吸收16例,软组织内异位钙化13例,骨质硬化6例,骨膜增生3例。结论超声检查是诊断长期血液透析患者DRA的首选方法,MRI能够作为超声的补充检查手段,进一步判断DRA的严重程度。Objective To explore the diagnostic value of magnetic resonance imaging(MRI)and ultrasound for dialysis-related amyloidosis(DRA)in patients undergoing long-term hemodialysis.Methods The clinical case data and imaging data of 60 DRA patients who underwent long-term hemodialysis and were admitted to the hospital from October 2013 to December 2018 were retrospectively analyzed.Results There were 51 patients(85.00%)and 49 patients(81.67%)with DRA diagnosed by ultrasound and MRI,respectively(P>0.05).In the diagnosis of 51 DRA patients by b-ultrasound,there was a strong echo of small patchy in the joint cavity or mild thickening of bone joints.There were no abnormal changes in bone.In the diagnosis of 49 DRA patients by MRI,there were 49 cases with joint synovial thickening,49 cases with articular cartilage erosion(16 cases of them were accompanied with subchondral bone resorption),35 cases with cystic bone destruction,28 cases with tendon and ligament injury,23 cases with osteoporosis,20 cases with joint swelling(including 7 cases with joint cavity effusion),16 cases with bone resorption,13 cases with ectopic calcification in soft tissues,6 cases with osteosclerosis and 3 cases with periosteal hyperplasia.Conclusion Ultrasonography is the first choice for diagnosis of DRA in patients undergoing long-term hemodialysis.MRI can be applied as the supplementary examination mean for an ultrasound to determine DRA's severity further.

关 键 词：血液透析 淀粉样变 磁共振成像 超声成像 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]