夏科氏关节病的CT及MRI特征表现分析

发布时间：2018-04-08 21:58

本文选题：关节病　切入点：神经源性　出处：《中国临床医学影像杂志》2015年05期

【摘要】：目的:探讨CT及MRI在夏科氏关节病(Charcot关节)诊断中的价值。方法 :回顾性分析经临床确诊的17例夏科氏关节病的CT及MRI影像资料,观察患者的影像特征表现。结果:17例患者,共19个病变关节,7个关节为吸收型,12个关节为增生型。CT特征:显示骨端的骨赘、崩解碎裂的骨块,观察骨块的空间位置关系,对骨损伤程度的评价更准确,VR重建能在任意角度旋转观察关节的对位关系、关节脱位的方向以及关节创伤情况,尤其对X线看不见的细小钙化和微小游离体的观察更有优势。CT平扫与重建对Charcot关节病的骨改变和关节扭曲、畸形的观察更加直观、形象。主要MRI特征:MRI的独到之处是可以清晰地显示出关节囊壁及囊壁外的其余软组织块影。关节囊壁不均匀增厚、松弛拉长,关节周围形成的软组织肿块多为不规则分叶状改变。T1WI上显示关节囊壁为等或稍低信号,T2WI为稍高信号,关节囊以外的软组织块影在T1WI上呈低信号,T2WI信号等高混杂信号影。关节腔内的积液可以表现为均匀的长T1长T2水样信号影,也可以表现为混杂信号影,这主要与是否并发感染、有无钙盐沉积或纤维肉芽组织增生有关。此外,MRI还能明确诊断关节软骨损伤程度及关节不稳定造成的肌腱、韧带的退变和拉伤。结论:夏科氏关节病的CT及MRI表现具有一定的特征性,二者结合,可以对疾病的骨质和软组织病变做出全面的评价。
[Abstract]:Objective: to evaluate the value of CT and MRI in the diagnosis of Charcot joint.Methods: Ct and MRI images of 17 patients with Charcot's arthropathy were retrospectively analyzed.Results there were 19 diseased joints in 17 cases, 7 joints were absorptive and 12 joints were hyperplastic. Ct features showed osteophyte at bone end, broken bone mass, and observed the spatial position relationship of bone mass.The evaluation of the degree of bone injury is more accurate. VR reconstruction can rotate at any angle to observe the relationship between joints, the direction of dislocation and the trauma of joint.Especially, the observation of small calcification and small free body which can not be seen by X-ray has more advantages. Ct plain scan and reconstruction can make the bone change and joint distortion of Charcot arthropathy more direct and more visual.The main feature of MRI is that it clearly shows the articular wall and other soft tissue masses outside the cyst wall.The wall of the articular capsule was unevenly thickened and loosely elongated. The soft tissue masses formed around the joint were mostly irregular lobular changes. On T1WI, the wall of the articular capsule showed iso-or slightly low signal intensity and slightly hyperintense on T2WI.The soft tissue mass outside the articular capsule showed low signal intensity and high signal intensity on T1WI.The effusion in articular cavity can be shown as homogeneous long T1 and long T2 water signal shadow or mixed signal shadow, which is mainly related to the presence of calcium salt deposition or fibrous granulation tissue proliferation.In addition, MRI can clearly diagnose the degree of articular cartilage injury and tendon, ligament degeneration and strain injury caused by joint instability.Conclusion: the CT and MRI findings of Charcot's arthropathy have some characteristics. The combination of CT and MRI can be used to evaluate the bone and soft tissue lesions of the disease.
【作者单位】：河北省沧州中西医结合医院CT室;
【分类号】：R684;R816.8;R445.2

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