摘要
目的 比较应用超声、CT及MRI诊 断髂腰肌囊扩张(EIB)的实用价值及其各 自的影像学表现。方法 收集我院2016年 1月-2018年6月诊治的EIB患者共100例的 超声、CT及MRI资料,所有患者经穿刺或 手术病理确诊,观察三种检查影像学表现 及其各自的确诊率。结果 共100例EIB患 者,86例为单侧病变,其中52例右侧,34 例左侧,14例双侧病变,超声表现为大小 不一囊性团块,形态规则,呈圆形、卵圆 形、扁椭圆形或长茄形,囊壁菲薄,边 缘清楚;扩张髂腰肌囊CT呈圆形、卵圆 形、水滴状囊性低密度影,大小不一,内 邻耻骨肌,止于股骨小转子水平;扩张 髂腰肌囊MRI呈圆形、卵圆形、水滴状分 房状囊腔,大小不一,呈长T1长T2水样信 号,T2WI呈高信号,T2WI及脂肪抑制序列 呈明显高信号,内前方为髂骨血管,外为 髂腰肌,后邻关节囊,可向上或向下延 伸;超声、CT及MRI对EIB确诊率差异有 统计学意义(P<0.05),且CT、MRI确诊率 显著高于超声(P<0.05)。结论 超声、CT 及MRI三种检查对EIB均有一定诊断价值, CT及MRI对EIB诊断率更高。
Objective To compare the imaging findings and the clinical value of enlarged iliopsoas bursa (EIB) of ultrasound, CT and MRI. Methods Imaging data of ultrasound, CT and MRI of 100 patients with EIB who were treated in our hospital from January 2016 to June 2018 were collected. All patients were diagnosed by puncture or surgical pathology. The imaging findings and confirmed diagnostic rate of the three examinations were observed. Results Of the 100 patients with EIB, 86 cases were unilateral lesions, including 52 cases in right side, 34 cases in left side and 14 cases in bilateral sides. And the ultrasound showed cystic masses of different sizes, and regular shape of round and oval, flat oval or long eggplant shape, the thin capsule wall and clear edge. The enlarged iliopsoas bursa was round, flat oval and drop-shaped cystic low-density shadow, with different sizes, and adjacent to the pectineal muscle, ending at the level of femoral trochanter under CT. The enlarged iliopsoas bursa was round, flat oval and drip-shaped compartmentalized cystic space, with varying sizes, with long T1 long T2 signal, and high signal in T2WI and significantly high signal in T2WI fat suppression sequences, and its anterior part was iliac vessels, the external part was iliopsoas and the posterior was joint capsule, and it could extend upward or downward. There was a statistically significant difference in the confirmed diagnostic rate of EIB by ultrasound, CT and MRI (P<0.05), and the confirmed diagnostic rate of CT and MRI was significantly higher than that of ultrasound (P<0.05). Conclusion Ultrasound, CT and MRI have their own advantages and disadvantages, and had certain diagnostic value for EIB, and the diagnostic rate of CT and MRI were higher than ultrasound.
【关键词】髂腰肌囊扩张;髋关节;超 声;CT;磁共振成像;诊断
【中图分类号】R6;R68
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.01.040
前言
髂腰肌囊指位于髋关节前方,由髂肌、腰大肌汇合肌腱与髋关 节、髂耻隆起间形成的滑液囊,有稳固髋关节作用,髂腰肌囊一般仅 有少量滑液,处塌陷状态,难以为影像学检查所见[1]。髂腰肌囊扩张 (enlarged iliopspasbursa,EIB)属于较少见的髋关节病变,常于滑膜 炎或髋关节病变后继发,患者临床表现以髋部疼痛、跛行、活动受限 为主,给生活和工作造成一定影响,明确诊断有利于采取正确干预措 施,对患者具有积极意义[2-3]。当前超声、电子计算机X射线断层扫描 技术(computed tomography,CT)及磁共振成像(Magnetic Resonance Imaging,MRI)均可用于EIB诊断,但三者之间的对比研究较少,本研究 旨在对比分析超声、CT及MRI在EIB诊断中的价值。
中国CT和MRI杂志
第17卷, 第 1 期
2019年01月
相关文章