长期血液透析患者骨关节影像表现

Imaging appearance of bone and joint in long-term dialysis recipients

目的分析长期血液透析患者骨关节改变的MRI表现，探讨X线平片、CT及MRI对透析患者相关骨关节病的诊断价值。方法对32例长期血液透析患者的肩、髋、手腕关节及腰椎进行X线平片、CT检查，其中26例行MR检查。结果32例患者X线检查见骨质疏松28例，骨吸收11例，囊性骨质破坏6例，骨质硬化11例，关节肿胀1例，软组织内钙化19例；32例患者CT见骨质疏松32例，骨吸收9例，囊性骨质破坏12例，骨质硬化11例，关节肿胀3例，软组织内钙化19例；26例患者MRI见骨质疏松6例，骨吸收2例，囊性骨质破坏14例，骨质硬化5例，关节肿胀15例，软组织内钙化1例。结论X线平片是观察血液透析患者骨改变的首选诊断手段；MRI是观察血液透析患者关节改变的首选诊断手段；在透析患者相关骨关节病的诊断与鉴别诊断方面，CT和MRI是X线平片重要的补充手段。

Objective To analyze the MRI characters of hemodialysis-related osteoarthropathy in long-term dialysis recipients, and to evaluate the diagnostic value of X-ray, CT, and MRI on hemodialysis- related osteoarthropathy. Methods The shoulders, hips, wrists and lumbar vertebraes of 32 patients underwent X-ray and CT examinations. Twenty-six of them received MRI examinations. Results In X-ray of 32 patients, 28 appeared osteoporosis, 11 showed bone resorption, 6 had cystic lesions, 11 had bone sclerosis, 1 had joint swelling, and 19 had soft tissue calcification. In CT of 32 patients, 32 appeared osteoporosis, 9 showed bone resorption, 12 had cystic lesions, 11 had bone sclerosis, 3 had joint swelling, and 19 had soft tissue calcification. In MRI of 26 patients, 6 appeared osteoporosis, 2 showed bone resorption, 14 showed cystic lesions, 5 had bone sclerosis, 15 had joint swelling, and 1 showed soft tissue calcification. Conclusions X-rays plain film is the first choice for the diagnosis of hemodialysis-related osteopathy, and MRI is the first choice for the diagnosis of hemodialysis-related arthropathy. CT and MRI is pretty useful in the diagnosis of hemodialysis-related osteoarthropathy.