长期血液透析患者肩关节MRI表现

Shoulder appearance at MR imaging in long-term dialysis recipients

目的:观察透析患者骨内损伤病灶的信号模式,评估冈上肌腱增宽对长期血液透析患者的诊断价值。方法:16例透析患者和16名健康志愿者进行MR检查,测量MR下肩关节冈上肌腱宽度。统计SE序列T1、T2加权像下骨内损伤病灶的信号模式。结果:透析组冈上肌腱宽度4.5～11.7mm;健康组冈上肌腱宽度3.6～5.9mm,存在显著差异(P(0.05)。骨内损伤病灶在MR T2加权像下呈低信号(5/12)、高信号(1/12)及混杂信号(6/12)。结论:长期血液透析患者经常可见冈上肌腱增宽,当MR下冈上肌腱宽度超过6mm时,可提示存在淀粉样蛋白沉积可能。冈上肌腱增宽程度与透析时间存在明显相关性。骨内损伤病灶在MR T2加权像下信号模式多种多样。

Objective：To observe the signal intensities of intraosseous lesions. To investigate the value of supraspinatus tendon thickness in diagnosing dialysis-related osteoarthropathy. Methods： 16 chronic dialysis recipients and 16 healthy volunteers underwent 1.5 T MR imaging with a combination of TSE-T1 WI and TSE-T2 WI sequences. The two groups were available for MR measurement and subjective assessment of supraspinatus tendon thickness. The differences of supraspinatus tendon thickness between dinlysis patients and healthy volunteers were compared. The criterion of supraspinatus tendon thickness was defined. The signal intensities of TSE-T1 WI and TSE-T3WI sequences, were noted. Results： The MR measurements of subscapularis tendon thickness of 16 dialysis＇patients ranged from 4.5 to 11.7 mm. The MR measurements of subscapularis tendon thickness of 16 healthy volunteers ranged from 3.6 to 5.9 mm. The two groups were believed to have obviously statistical differences （ P 〈 0.01）. 12 intraosseous lesions were clearly shown. Low, high, arid mixed signal intensities were observed in five, one, and six lesions, respectively, on T2-weighted images. Conclusion：Supraspinatus tendon thickening is common in chronic dialysis recipients. It is considered dialysis-related amyloidosis osteoarthropathy when subscapularis tendon thickness beyonds 6 mm. The results of regression analysis suggest that an association between measurements of subscapularis tendon thickness and dialysis duration existed. Bone lesions in such patients are of variable T2 signal intensity.