双侧髂腰肌囊扩张症的磁共振影像诊断特征分析

目的探讨双侧髂腰肌囊扩张症的磁共振成像(MRI)诊断特征。 方法收集分析2014年12月至2018年5月丰县人民医院影像科MRI诊断的13例双侧髂腰肌囊扩张症患者的临床资料。 结果共诊断75例髂腰肌囊扩张症，双侧发病者仅13例，双侧发病率为17.3%(13/75)，13例中10例为股骨头坏死(双侧6例，单侧4例)，2例有髋部创伤史，1例为盆腔MRI检查时偶然发现。共37房囊性病灶，其中两侧均为单房囊性灶5例，两侧均为双房囊性灶3例，右侧双房、左侧单房囊性灶病灶3例，右侧单房、左侧双房囊性灶2例。21房病灶信号较均匀呈水样、欠均匀16房，7房病灶内部见分隔。病灶呈圆形、卵圆形或泪滴样，大小5 mm×3 mm×8 mm至27 mm×23 mm×51 mm。病灶位于髋关节囊前方、髂腰肌(腱)内侧、外侧、后部或其肌间隙，22房病灶可见与髋关节腔相通。对10例伴发的股骨头坏死、2例伴发的髋臼挫伤及肌挫伤、1例股骨颈疝窝均能较好显示。 结论MRI可明确显示位于特定解剖部位、具有较为特征性MRI信号特点的双侧髂腰肌囊扩张症，并可进行病因诊断。

MRI manifestations of bilateral iliopsoas bursa expansion

ObjectiveTo investigate the magnetic resonance imaging (MRI) features of bilateral iliopsoas bursa expansion. MethodsFrom December 2014 to May 2018, 13 cases of bilateral iliopsoas bursa expansion diagnosed by MRI in People′s Hospital of Fengxian were enrolled. ResultsA total of 75 cases of iliopsoas capsular dilatation were diagnosed by MRI, and only 13 cases were bilaterally affected. Among the 13 cases, 10 cases were femoral head necrosis (bilateral in 6 cases, unilateral in 4 cases), 2 cases had hip trauma history, and 1 case was accidentally found during pelvic MRI. The incidence of bilateral involvement was 17.3% (13/75), with 37 cystic lesions, including unilocular lesion on each side in 5 cases, biatrial cystic lesions on each side in 3 cases, biatrial cystic lesions on the right and one cystic lesion on the left in 3 cases, unilocular cystic lesion on the right and biatrial cystic lesions on the left in 2 cases. The lesions displayed homogeneous water signal in 21 lesions and unhomogeneous signal in 16 lesions, and 7 lesions had separation inside. The lesions were round, oval or teardrop shaped and the size of the lesions range from 5 mm×3 mm×8 mm to 27 mm×23 mm×51 mm.The lesions located in front of the hip joint capsules, and internal-external-posterior or medial to iliopsoas muscle (tendon), 22 antra cysts communicated with the joint cavity. MRI also better showed femoral head necrosis in 10 cases, acetabular contusion and muscle contusion in 2 cases and femoral neck herniation fossa in 1 case. ConclusionMRI can clearly show bilateral iliopsoas bursa dilatation which locates in a specific anatomical site and has a characteristic feature of MRI signal, and can be used for etiological diagnosis.