摘要
目的:探讨膝关节痛风性关节炎的CT和MRI影像特征。方法:回顾分析经手术病理证实的21例膝关节痛风性关节炎的CT和MRI表现,其中12例CT,14例MRI。结果:所有病例均能发现痛风结节,CT显示45个,MRI显示48个,痛风结节位于肌腱和韧带共58个,滑膜或关节腔内15个,骨内11个,其他软组织9个。形态呈条块状31个,结节状31个,线状4个,不规则形27个。骨质破坏CT共发现21处,MRI发现24处,位于骨边缘共30处;MRI显示5处骨质破坏周围骨髓水肿。痛风结节在T1WI均呈低至中等信号;T2WI上39个呈混杂信号,6个呈高信号,3个呈低信号。在5例均行CT及MRI检查膝关节比较中:CT显示痛风结节21个,MRI显示痛风结节18个;CT和MRI在显示骨质破坏的部位均为12处,MRI显示骨髓水肿4处;MRI显示软骨异常共5处。结论:膝关节痛风性关节炎在影像上有一定的特征性,CT更容易发现痛风结节,而MRI更合适于评估软组织情况及炎性改变,综合分析两种影像资料有助于准确诊断痛风性关节炎。
Objective： To explore the CT and MRI features of gouty arthritis in the knee. Method： The CT （12） and MRI （14） features of 21 patients with pathologically confn＇rned gouty arthritis in the knee were analyzed retrospectively. Results： Tophus was found in all patients, including 45 cases of CT, 48 cases of MRI. There were 58 tophus deposited in ligaments and tendons, 15 in synovium or intra-articular, 11 in the bone, 10 in other places. Tophus showed strip 31, nodular 31, linea 4, or irregular contour 27.21 lesions of bone erosion were found in CT, 24 lesions in MRI. 30 lesions of bone erosion were found located in the edge of bones. Bone edema was found around 5 lesions of bone erosion on MRI imagings. On T1WI imagings, the tophus showed hypointensity to isointensity. On T2WI imagings, 6 tophus showed hyperintensity, 3 tophus showed hypointensity, and 39 tophus showed heterogeneously signal intensity. CT showed 21 tophus, whereas MILl showed 18 tophus in 5 patients who received both CT and MRI scan. 12 lesions of bone erosion were found on CT, MR1, respectively. 4 lesions of bone edema and 5 lesions of cartilage abnormal were found on MRI. Conclusion： Some image features of gouty arthritis in the knee are specific. CT may best evaluate tophus, whereas MRI is suitable to evaluate soft tissues, inflammatory changes. Comprehensive analysis of multiple imaging examinations is helpful for the diagnosis of gouty arthritis.
出处
《CT理论与应用研究（中英文）》
2014年第3期489-496,共8页
Computerized Tomography Theory and Applications
