论文部分内容阅读
目的分析关节滑膜结核的 X 线、CT 及 MRI 表现,探讨 MRI 在早期关节滑膜结核诊断中的作用。方法回顾分析14例经手术病理证实的关节滑膜结核的影像学资料并进行总结。14例均行常规 X 线正侧位摄片及 MR 平扫,其中3例(膝关节2例、肘关节1例)同时行 CT 平扫。结果 X 线表现:14例中关节肿胀8例,关节间隙变窄7例,关节骨质破坏4例。CT 表现:3例均显关节囊肿胀、积液。2例关节面见小破坏灶,内见点状死骨。MRI 表现:14例病变关节均表现为滑膜不同程度增生肥厚,其中8例见增生滑膜呈结节状、团块状,增厚滑膜在 T_1WI 均呈低信号,T_2WI 上为不均匀略高信号7例,较明显高信号6例,1例 T_2WI 上呈中等偏低信号。关节内及关节周围积液7例。关节面边缘破坏7例。关节软骨变薄,部分或大部分破坏消失11例。关节骨端邻近骨质骨髓水肿7例。结论 MRI 对滑膜结核的早期诊断、鉴别诊断帮助较大,优于 X 线和 CT。
Objective To analyze the X-ray, CT and MRI findings of synovial tuberculosis and to explore the role of MRI in the diagnosis of early synovial tuberculosis. Methods Retrospective analysis of 14 cases of pathologically confirmed synovial tuberculosis imaging data and summary. All 14 cases underwent routine X-ray radiography and MR plain scanning. Among them, 3 cases (2 cases of knee joint and 1 case of elbow joint) underwent CT scan at the same time. X-ray findings: in 14 cases of joint swelling in 8 cases, joint narrowing in 7 cases, 4 cases of joint bone destruction. CT manifestations: 3 cases showed joint capsule swelling, effusion. 2 cases of small joint surface see the destruction of foci, punctate see within the dead bones. MRI findings: The 14 cases of joint showed synovial hyperplasia of varying degrees of hypertrophy, including 8 cases of hyperplastic synovial nodular, massive, thickening synovium in T_1WI were low signal, T_2WI uneven High signal in 7 cases, more obvious high signal in 6 cases, 1 case of T_2WI was moderate lower signal. Intra-articular and joint effusion in 7 cases. Articular surface edge damage in 7 cases. Articular cartilage thinning, partial or most of the destruction disappeared in 11 cases. 7 cases of bone marrow edema near the bone end of the joint. Conclusion MRI diagnosis of synovial tuberculosis early, differential diagnosis help larger, better than the X-ray and CT.