神经性关节病的影像诊断(附6例分析)

目的:分析并比较神经性关节病的X线、CT及MRI的影像学表现,评价X线、CT及MRI对神经性关节病的诊断价值。材料与方法:对6例神经性关节病的综合影像表现进行回顾性分析,所有患者均行X线及CT检查,其中4例行MRI检查。结果:X线可见临近关节的骨端密度增高,且密度不均,关节面不规则、硬化。关节间隙变窄或增宽,关节腔内可见多发游离体,关节畸形。关节周围软组织肿胀,其内可见钙斑。可见轻度骨膜反应。CT对于关节腔内多发游离体、关节腔积液、关节周围软组织显示优于X线。CT可区分高密度影是关节腔游离体还是软组织内钙化或关节囊钙化。MRIT1WI可见关节间隙变窄或增宽,关节软骨破坏消失,关节腔内有境界清楚信号均匀的低信号影。临近关节的骨髓信号减低且信号不均,其内有小囊状高信号。T2WI显示关节腔积液呈均匀高信号,于高信号的关节腔积液内可见不规则极低信号影。结论:X线是诊断神经性关节病的首选和基本方法。CT可清楚显示病变关节的内部改变,有助于确定诊断,CT与X线结合对于诊断神经性关节病的诊断有重要意义。MRI是对X线和CT的必要补充。

Imaging diagnosis of neurotrophic joint(analysis of 6 cases)

Obje ct ive:To analyze and compare the X-ray,CT and MRI features of neurotrophic j oint and evaluate the diagnostic value of the X-ray,CT and MRI for the neu rotrophic joint.Materials and Methods:The imaging of six cases with neurotrop hic joint were reviewed retrospectively,all cases were examined by X-ray and CT,four cases were examined by MRI simultaneously.Results:On X-ray film d emonstrated the increase and unhomogeneous of the osseous density near the join ts;the irregularity and sclerosis of the joint surface;broaden or narrow of the joint interspace.It also can clue on multi-freebodys in the joint cavi ty,joint deformity,swelling of the soft tissue around the joint with calcif ication and the lowgrade periosteum reaction.CT scan is better than X-ray in d isplaying multi-freebodys in the joint cavity,hydrops of the joint cavity a nd the soft tissue around the joint.CT can differentiate freebodys in the joint cavity with the calcification of the soft tissue or joint sac.MRI can sho w us broaden or narrow of the joint interspace,destruction or disappearance of the joint cartilage.T 1 WI manifestation is homogeneous hypo-signal with clear bourn in joint cavi ty and the signal brings down in the bone mar-row near the joint with some h igh signal cystoids.T 2 WI displayed the hydrops of the joint cavity is homogeneous hyper-signal with irregular extreme hypo-signal in it.Conclusion:X-ray is the preferred and basic method in diagnosis of the neurotrophic joint.CT can show the inner changes of the lesion clearly,can help definitive diagnosis.And CT connect wi th X-ray is im-portant in diagnosis.MRI is necessary complement to CT and X-ray.