摘要
目的 探讨Charcot关节的MRI表现 ,评价X线片、CT及MRI对Charcot关节的诊断价值。方法 对 8例Charcot关节作X线、CT及MR检查 ,其中 6例患有脊髓空洞症 ,1例为胸髓损伤截瘫患者 ,1例为糖尿病患者 ,所有 8例均有患肢的痛觉减退或消失。结果 ( 1)Charcot关节表现为增生和吸收 2型。 ( 2 )X线及CT特点 :3例增生型关节骨质增生硬化、骨赘形成 ,关节周围软组织肿胀 ,内见大量块状骨化影 ;5例吸收型关节以骨质破坏吸收、碎裂为主 ,骨端消失 ,其中 3例残端平齐如手术切除 ,周围软组织肿胀 ,内见多个小而锐利的骨化影。 8例中有 3例伴有关节半脱位。 ( 3)主要MRI特点 :8例均清楚显示关节周围软组织块影结构 ,7例分为 3层 :由内向外为关节囊内积液、关节囊壁及囊壁外其余软组织块影 ,1例关节囊壁与其外软组织块影分界不清 ,表现为 2层结构。关节囊壁不均匀增厚、松弛及拉长 ,在关节周围、骨干旁或肌间隙内呈伪足状伸延 ,T1WI呈稍低信号 ,T2 WI呈稍高信号 ,注射钆喷替酸葡甲胺 (Gd DTPA)后明显强化 ,其强化程度常高于外周的软组织块影。关节周围软组织块影的 3层结构及关节囊的改变较具特点。结论 X线片是Charcot关节的首选诊断手段 ,MRI在Charcot关节的诊断及鉴别诊断方面是X线片重要的补充手段。
Objective To analyze the MRI characters of Charcot joint, and to evaluate the diagnostic value of X-ray, CT, and MRI on Charcot joint. Methods Eight patients with 8 Charcot joints underwent X-ray, CT, and MR examinations. 6 of them had syringomyelia, 1 patient had injury of the spinal cord, and 1 case had diabetes. All 8 patients had sensory reduction or deficit in the sick extremities. Results There were two types of Charcot joint, hypertrophic and atrophic. Radiographic and CT features of hypertrophic joint (n=3) showed hyperostotic osteosclerosis and mammoth osteophytes in the sick bones, periarticular ossification,and articular disorganization. Radiographic and CT features of atrophic joint (n=5) showed extensive bone resorption (destruction), periarticular debris, and articular disorganization. Main MRI features of Charcot joint included hydrarthrosis within joint capsule, thickened, loose, and elongated joint capsule with para-joint, peri-diaphysis, and inter-muscular extension in a pseudopodia pattern. The irregular joint capsule wall was presented as mild hypointensity on T 1WI, slight hyper-intensity on T 2WI, and was markedly enhanced after Gd-DTPA was administrated, which was considered as a characteristic manifestation of the lesion. Soft tissue mass containing hypo-intense stripes on both T 1WI and T 2WI was commonly noted adjacent to the involved joint. Conclusion X-rays plain film is the first choice for the diagnosis of Charcot joint, and MRI is pretty useful in the diagnosis of Charcot joint.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2003年第5期428-432,共5页
Chinese Journal of Radiology
