血友病性关节病的MRI分析

目的:探讨血友病性关节病的MRI表现及临床价值.方法:回顾性分析11例22个膝关节血友病性关节病患者的MRI表现.结果:22个膝关节均有积血,表现为关节腔、骨骼和/或软组织血肿,早期血肿在T1WI为等信号、T2WI呈高信号;中期血肿在T1WI呈略高信号或混杂信号,T2WI呈高信号或混杂信号;晚期血肿在T1WI和T2WI均表现为混杂信号,血肿逐渐被吸收.病变早期关节结构基本保持正常,中晚期关节结构均有损害,表现为关节软骨、骨皮质破坏吸收,关节间隙狭窄,骨端或骨骺增大变形.早中期滑膜、关节囊、肌肉及韧带肿胀,而晚期则萎缩、退变.结论:MRI能准确显示血友病性关节病的病理改变,对疾病分期、指导临床治疗及同位素放射治疗效果评价具有重要意义.

MRI Features of Hemophilic Arthropathy

Objective:To evaluate the MRI features in the diagnosis of hemophilic arthropathy and their clinical value of hemophilic arthropathy.Methods:MRI features of 11 cases (22 knee joints) with hemophilic arthropathy were analyzed retrospectively.Results:Blood accumulation were showed in all 22 knee joints,manifested as hematoma within joint cavity,bone and/or soft tissue.For early stage hematoma,the signal intensities were iso-intensed on T1WI,hyper-intensed on T2WI;basically normal articular structure was maintained.For mid stage hematoma,the signal intensities showed slightly hyper-or mixed intensities on T1WI,hyper-or mixed intensities on T2WI.For late stage,mixed signal intensities were showed on both T1WI and T2WI,the hematoma was gradually absorbed.Damage of articular structure included destruction of articular cartilage and bony cortex,narrowing of inter-articular space,enlargement and distortion of epiphysis and bone termination.Swollen of synovium,articular bursas muscles and ligaments were revealed in the early and mid stages,while atrophy and degeneration were showed in the late stage.Conclusion:The pathology of hemophilic arthropathy can be sophisticatedly displayed on MRI,which is very helpful for the staging,treatment guiding and evaluating the therapeutic effect of isotopic radiation.