化脓性髋关节炎的CT与MRI表现

CT and MRI findings of septic hip arthritis

目的分析化脓性髋关节炎的CT与MRI表现,并评价其临床意义。方法回顾性分析30例经临床和手术病理证实的化脓性髋关节炎患者的CT与MRI表现,其中,行CT检查24例,MRI检查15例,同时行CT与MRI检查者9例。结果在CT与MR像上,软组织肿胀分别见于20例和14例,关节腔积液分别见于24例和15例,滑膜及肉芽组织增生分别见于13例和11例,关节间隙改变分别见于13例和9例,骨质改变分别见于24例和15例。CT显示骨内积气4例,MRI显示软组织脓肿1例。结论 MRI对化脓性髋关节炎的早期病理改变,诸如少量关节腔积液、邻近软组织轻度肿胀以及骨质早期改变的显示,明显优于CT,但是CT对骨内积气和骨质晚期改变的显示优于MRI。CT与MRI在化脓性髋关节炎诊断与指导治疗中起重要作用。

Objective To analyze the computed tomography（CT） and magnetic resonance imaging（MRI） findings of septic hip arthritis and to assess their clinical significance. Methods CT and MRI findings of 30 patients with clinically,surgically and pathologically proved septic hip arthritis were analyzed retrospectively. Of whom,twenty-four patients underwent CT examinations,fifteen patients underwent MRI examinations,and nine patients underwent both examinations as mentioned above. Results On CT and MR images,soft tissue swelling was found in 20 and 14 cases,respectivly;hydrarthrosis in 24 and 15;proliferation of synovium and granulation tissue in 13 and 11;arthral space change in 13 and 9;bony change in 24 and 15.CT scans shown intra-osseous pneumatosis in 4 cases,MRI shown soft tissue abscess in 1 cases. Conclusion MRI in visualizing early pathologic changes of septic hip arthritis such as small hydrarthrosis,slight swelling of neighbor soft tissue and early bony changes is significantly superior to CT but CT in visualizing intra-osseous pneumatosis and late bony changes is superior to MRI. CT and MRI play important role in the diagnosis and guiding treatment of this disease.