痛风性膝关节炎的MRI诊断

MRI diagnosis of gouty arthritis of knee

目的探讨痛风性膝关节炎的MRI表现及诊断价值。方法回顾性分析22例经关节镜或手术病理证实的痛风性膝关节炎患者31个膝关节的MRI资料,并与手术病理进行对照分析。结果 31个膝关节均表现为滑膜增厚,26个关节见积液,29个关节可见痛风结节形成,多位于髌上囊、髌下囊、前后交叉韧带周围及髁间窝、股四头肌肌腱、髌韧带及腘肌腱周围,伴邻近膝关节骨质侵蚀破坏及骨髓水肿,痛风结节T1WI均呈等或低信号,T2WI呈低、稍高混杂信号或高信号。结论 MRI可以清晰显示痛风性关节炎滑膜增厚、关节积液及关节周围软组织肿胀,对于观察痛风石和邻近骨质的破坏、骨髓水肿等具有很高的敏感性,是诊断痛风性膝关节炎非常有效的影像检查方法。

Objective To explore the imaging features of MRI in the patients with gouty arthritis of knee and the diagnostic value. Methods The MR imaging and clinical date of 31 knees in 22 patients with gouty arthritis of the knee confirmed by pathology were retrospectively analyzed. Results All of the 31 knees showed synovial thickness, 21 knees showed hydrarthrosis. 29 knees had the gouty tophus which located at the patella bursa, patellar fat pad, joint cavity, intercondylar fossa, femoral condyle or surrounding, patella or before, and tibial platform or before. Tophi showed hypointensity on T1WI, showed isointensity, slight hyperintensity , and hypo-/slight hyper -intensity on T2WI. Conclusion MRI is very effective image examination method of diagnosis the gout arthritis of the knee, MRI can clearly show synovial thickeness, hydrarthrosis and soft tissue swelling, sensitively observe the bone erosion and the gouty tophi.