髋关节周围滑囊炎MRI诊断及鉴别诊断

目的 研究髋关节周围滑囊炎的MR表现,探讨其临床及影像学表现的关系.方法 回顾性分析15例经穿刺或手术病理证实的髋关节周围滑囊炎MR资料,患者包括男性8例和女性7例,年龄为43～70岁,平均58岁,所有病例都进行了MR平扫和增强扫描.MRI资料由2名放射科医师阅片并取得一致性意见,对病变的部位、大小及内在特征作出评价.结果 15例病灶均表现为圆形或椭圆形囊性占位.囊内信号特点：在T1加权像,与邻近肌肉相比,表现为低信号;所有15例在T2加权像上都呈极高信号,10例信号均匀.5例信号不均匀：囊壁信号特点：在T1加权及T2加极像上囊壁均显示不清;其中4例有分隔,11例无分隔.DWI图信号很低,ADC图明显高信号,ADC值极高,平均ADC值为2.98×10-3mm2/s;增强扫描示囊内无强化,囊壁及分隔轻度强化且厚薄不均.结论 髋关节周围滑囊炎MR表现有特征性,包括特定部位、在T2WI呈明显高信号等,依据典型MR表现可以作出正确诊断.

MRI Diagnosis and Differential Diagnosis of Bursitis in Periphery of Hip Joint

Objective To research the MR imaging characteristics of bursitis in periphery of hip joint,and to study the relationship of imaging features with clinical data.Methods MR1 study of 15 patients with pathologically confirmed bursitis in periphery of hip joint were retrospectively reviewed.The patients include 8 males and 7 females,aged from 43 to 70 years.All 15 patients were examined with pre-contrast and post-contrast MR scans. MR images were evaluated by two radiologists with agreement by consensus for lesion location, lesion size,and intrinsic characteristics.Results 15 cases showed round or oval cyst.The signal intensity within the bursitis on TI- weighted image（WI） was hypo-intense in comparison to that of surrounding muscles.On T2-WI,the bursitis were hyper-intense in all cases;it was heterogeneous in 5 cases and homogeneous in 10 cases.On T I-Wl and T2-Wl,the wall of bursae can not be seen.There was septation in 4 cases and no septation in remaining 11 cases.The signal intensity within the bursitis on diffusion-weighted image was hypo-intense,and hyper-intense in Apparent diffusion image,the average ADC（apparent diffusion Coefficient） value is 2.98 x 103mm2/s.With contrast enhancement,the wall and septation of the bursae were strengthened in all cases.Conclusions Bursitis in periphery of hip joint often demonstrate characteristic MRI findings, including location, high signal intensity on T2-WI.And the correct diagnosis can be made based on typical MR findings.