二羟焦磷酸钙晶体沉积症的影像学诊断

Radiological diagnosis of calcium pyrophosphate dihydrate crystal deposition disease

[目的]探讨二羟基焦磷酸钙晶体沉积症（CPPD—CDD）的影像学特征，提高诊断准确率。[方法]收集37例CPPD—CDD的影像学及临床资料，并进行回顾性分析。[结果]男20例，女17例，发病年龄35—80岁，平均53±2．1岁，中位年龄55岁。病变主要累及膝、肩等大关节，其中膝关节发病19例（51．35％），肩关节6例（16．22％），多关节发病10例（27．03％）。部分病例滑液中可查到焦磷酸钙晶体。主要影像学征象包括关节软骨钙化（20例）、纤维软骨钙化（10例）、关节囊或关节周围软组织钙化（12例）、焦磷酸盐性关节病（8例）。[结论]二羟焦磷酸钙晶体沉积症的影像学诊断应密切结合其临床表现及实验室检查，并应与二羟基磷酸二钙（DCPD）晶体沉积、羟磷灰石（HA）晶体沉积、类风湿性关节炎、钙化性关节周围炎和肌腱周围炎等关节病变相鉴别。

[ Objective ] The aim of the study was to investigate the radiological characteristics and improve accurate diagnosis of calcium pyrophosphate dihydrate crystal deposition disease（CPPD-CDD）. [ Method] The radiological and clinical data of CPPD-CDD of 37 cases were collected and analyzed retrospectively. [ Result] In the 37 cases ,20 were male and 17 were female, age range 35-80 years, mean age 53± 2.1 years, median age 55 years. It is most common in the knee, shoulder joints, in which of knee joint onset in 19 cases （51.35% ）, shoulder in 6 cases （ 16.22% ）, more than one joints onset in 10 cases （27.03%）. CPPDCDD crystals were discovered in the joint fluid of the part cases. Mainly radiological signs of it may be as chondrocalcinosis in 20 cases ,fibrocartilaginous calcifications in 10 cases, capsular and around soft tissues calcifications in 12 cases, pyrophosphate arthropathy in 8 cases. [ Conclusion] The definite or probable radiological diagnosis of CPPD-CDD may closely associate with clinical and lab data, and be differentiated with dicalcium phosphate dihydrate（DCPD） crystal deposition, calcium hydroxyapatite （HA） crystal deposition ,rheumatoid arthritis ,calcific periarthritis and peritendinitis and so on.