摘要
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 MRI finding of tuberculosis of sacro-iliac joint (SITB) so as to promote the diagnostic accuracy. Methods The CT and MRI 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 MRI scan. MRI scan, In 10 of the cases, fat-saturated contrast-enhanced. Results All the cases had unilateral 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 surface, 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.
【关键词】结核;骶髂关节;磁共振成 像;体层摄影术,X线计算机
【中图分类号】R529.2
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.02.042
前言
骶髂关节结核在临床上少见,约占骨关节结核10%[1],其临床表现 不典型,易与骶髂关节其他疾病相混淆,临床上有很高漏诊、误诊 率。CT和MRI不仅能显示骶髂关节的解剖结构、骨质破坏和冷脓肿,而 且MRI能显示骨髓水肿、软组织肿胀及软骨破坏,为骶髂关节结核提供 重要影像学依据。笔者搜集本院经临床手术病理证实的20例骶髂关节 结核,回顾性分析其CT及MRI表现,以提高骶髂关节结核诊断和鉴别诊 断水平。
中国CT和MRI杂志
第15卷, 第 2 期
2017年02月
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