骶髂关节结核的CT和MRI诊断

CT and MRI Diagnosis of Tuberculosis of Sacro-iliac Joint

目的探讨骶髂关节结核的CT和MRI表现,提高其诊断准确性。方法回顾性分析经手术病理证实的骶髂关节结核20例。对所有病例均作CT和MRI平扫,其中10例同时行脂肪抑制T1WI增强检查。结果 20例骶髂关节结核均为单侧发病,其中右侧12例,左侧8例,典型CT和MRI表现为关节面模糊、骨质破坏、关节间隙增宽,关节周围软组织肿胀,可伴冷脓肿和窦道形成,严重者关节半脱位,纤维强直或骨性强直。结论 CT及MRI能精确显示骶髂关节破坏程度、类型、脓肿位置及临近结构,有助骶髂关节结核的诊断及鉴别诊断。

Objective To discuss the CT and MP, I finding of tuberculosis of sacro-iliac joint （SITB） so as to promote the diagnostic accuracy. Methods The CT and MR1 finding of 20 cases with tuberculosis of sacro-sacro-iliac joint （SITB） proved by surgery and pathology, were analyzed restrospectively. All 20 cases underwent CT and MP, I scan. MRI scan, In 10 of the cases, fat-saturated contrast-enhanced. Results All the cases had nnilateral joint lesion. Of the 20 cases, the lesion was located at left sacro-iliac joint in 8 cases and at right side in 12 cases. The typical CT and MRI finding were as followed： the manifestations presented by blurred articular snrface, bony destruction, widened articular space and acute inflammatory soft tissue around articular associated with cold abscess and sinus. Severe cases manifested by joint subluxation and fibrous or bony ankylosis. Conclusion CT and MRI could accurately display the degree and type of sacro-iliac joint destruction, the region of abscess and adjacent structures, which could contribute to diagnosis and differential diagnosis the sacro-iliac joint tuberculosis.