膝关节结核的MRI表现

目的探讨膝关节结核的MRI表现及其临床应用意义。方法回顾性分析本科2003年3月～2005年12月，经关节镜手术及病理检查证实的影像学资料完整的19例患者20个膝关节结核，其中单纯左膝6例，单纯右膝12例，双膝1例。全部病例行膝关节ArtoscanC四肢关节专用扫描系统矢状位、冠状位、横断位MR扫描。结果单纯滑膜结核4例，滑膜结核合并半月板损伤、关节软骨损伤、交叉韧带损伤共6例，全关节结核10例。滑膜增生MRI在T1WI上呈较为均一中低信号表现．T2WI上呈中高低信号混杂表现。骨质的破坏以及骨髓水肿等改变在脂肪抑制序列可清晰显示，骨质破坏可见关节液及滑膜浸入．骨髓水肿可见骨髓内部的局限性或弥漫性高信号。结论MRI能早期发现关节结核病变．明确病变累及的程度和范围，判定关节破坏程度．有助于膝关节结核的早期诊断与选择合理治疗方式。

Value of MRI in evaluating tuberculosis of knee joint

Objective To identify the value of MRI in evaluating tuberculosis of knee joint.Methods To we retrospectively analyze MRI appearance of 19 patients(20 knees) of tuberculosis of knee joint which proved by pathology and surgery from March 2003 to December 2005.Among the 20 knees,there are 6 patients with tuberculosis of left knees,12 patients with tuberculosis of right knees and 1 patient with tuberculosis of both knees.All the 20 knees were checked with Artoscan MR machine.Results Among the 20 tuberculosis of knees,4 cases only with tuberculosis of synovium,6 cases with tuberculosis of synovium,cartilage,ligament except for the bone,and 10 cases with tuberculosis of synovium,bone and other parts of the knee.On the T-1 weight images,we could find homogenic low to middle intensity signal of the hyperplastic synovium;on the T-2 weight images,we could find mixed signal intensity of middle or high signal of the hyperplastic synovium.Other lesions such as articular cartilage destruction,bone erosion,joint effusion,meniscus and ligament lesion,popliteal cysts and subcutaneous nodule formation were depicted clearly by MR imaging.Conclusion The MRI scan can accurately estimate the lesion of tuberculosis of the knee.MRI can provide lots of useful information for diagnosis and treatment of tuberculosis of the knee.