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肾性骨营养不良骶 髂关节病变CT表现

作者:郭永飞 韦彩琴 杨宇凌 余水全 李水连

所属单位:广东省中山市中医院CT室 (广东 中山 528401)

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摘要

目的 分析肾性骨营养不良(ROD) 患者骶髂关节改变的CT特征,以提高对其 的认识水平。方法 回顾分析25例ROD患者 的骶髂关节病变CT特点及临床资料。其中 男14例,女11例,年龄29-69岁,平均49 岁。分析ROD骶髂关节骨质病变的部位、 骶髂关节间隙、密度、边界、周围骨质及 软组织情况。结果 所有ROD患者均为双侧 骶髂关节髂骨侧骨质受累,并伴有其它 多种ROD影像表现,包括骨质疏松23例、 骨质软化21例、骨质硬化9例、棕色瘤10 例、软组织异常钙化15例及病理性骨折5 例,35个骶髂关节间隙正常,15个间隙增 宽,17个骶髂关节见双边征。结论 ROD骶 髂关节受累表现为双侧髂骨侧骨质破坏, 多伴发多种ROD影像表现,双边征及关节 间隙增宽具有特征性,结合ROD其它影像 征象及临床病史可提高对骶髂关节病变的 诊断率。CT对其诊断具有一定的价值。

Objective To analyze the CT features of sacroiliac joint in renal osteodystrophy (ROD) patients, and to improve the understanding of it. Methods The clinical and imaging data of 25 patients (14 male, 11 female) with ROD were analyzed retrospectively. In the 25 cases, the age was from 29 to 69 years with median age of 49 years. CT features included: density, positions, boundary, joint clearance, bone and soft tissue around the lesions. Results All ROD patients were bilateral sacroiliac joints iliac bone involvement, accompanied by a variety of other ROD image performance, including osteoporosis(23 cases), Osteomalacia (21 cases), bone sclerosis(9 cases), brown tumor(10 cases), abnormal soft tissue calcification(15 cases), pathologic fracture(5 cases), ormal sacroiliac joint clearance(35 lesions), gap widened(15 cases), double-line sign(17 cases). Conclusion The involvement of the sacroiliac joint in renal osteopathy is bilateral bone destruction of the iliac side, with a variety of ROD image performance, double-line sign and joint gap widened were its characteristics, combined with the other imaging manifestations and clinical history can improve the diagnostic rate of sacroiliac joint lesions. CT has a certain value in its diagnosis.

【关键词】肾性骨营养不良;骶髂关节; 体层摄影术,X线计算机

【中图分类号】R814;R692.9

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.03.040

前言

肾性骨营养不良(renal osteodystrophy,ROD)是由于慢性肾病患 者体内钙磷代谢紊乱及内分泌失调而导致的骨病,是长期血液透析常 见的严重并发症[1],而髂骨是肾性骨营养不良的常见部位[2]。笔者搜 集本院25例ROD伴发骶髂关节骨质破坏病例,探讨CT影像特征,旨在提 高对该病CT表现的认识。