膝关节痛风性关节炎MRI表现分析

目的分析膝关节痛风性关节炎的MRI表现,探讨其诊断价值。材料与方法21例膝关节痛风性关节炎均行MRI检查,并对影像资料进行分析。结果21例均表现为膝关节滑膜增厚、关节腔积液及膝关节周围软组织肿胀。12例可见膝关节骨质侵蚀破坏,位于股骨髁内或边缘,胫骨平台、髌骨、腓骨头等,表现为长T1、长T2信号影。3例伴有不同程度骨髓水肿。11例可见痛风石形成,多位于髌上囊、髌下脂肪垫、关节腔、髁间窝、股骨髁内或旁、髌骨内或髌骨前、胫骨平台内或胫骨前方等;呈针状、条状、结节状、团块状;信号无特异性,T1WI上,4例呈低信号,7例呈低及等信号;T2WI上,2例呈低信号,5例呈稍高信号,4例呈低及稍高混杂信号。结论膝关节痛风性关节炎早期,MRI可以敏感观察到滑膜增厚、关节腔积液、周围软组织肿胀,但是表现无特异性;MRI对于膝关节痛风性关节炎合并有骨质破坏及痛风石形成的诊断特异性高。

Analysis on the magnetic resonance imaging features of gouty arthritis of the knee

Objective: To analyse the MRI features of gouty arthritis of the knee and discuss its diagnosis value. Materials and Methods: Twenty-one cases with gouty arthritis of the knee underwent knee MRI plain scan. MRI findings were retrospectively reviewed. Results: All of the 21 cases showed synovial thickness, hydrarthrosis, and soft tissue swelling. Twelve patients had the bone erosion which located at the femoral condyle, tibial plateau, patella, fibular head and showed hypointensity on T1WI and hyperintensity on T2WI. Bone edema was seen in 3. Eleven cases had the gouty tophus which located at the patella bursa, patellar fat pad, joint cavity, intercondylar fossa, femoral condyle or surrounding, patella or before, and tibial platform or before. The gouty tophus displayed as acicular, strip, nodosity or mass. Magnetic resonance signals had no specificity. Gouty tophus showed hypointensity (n=4), iso-/hypo- intensity (n=7) on T1WI, hypointensity (n=2), slight hyperintensity (n=5), and hypo-/slight hyper-intensity (n=4) on T2WI. Conclusions:To the early stage of gout arthritis of the knee, MRI can sensitively observe synovial thickeness, hydrarthrosis and soft tissue swelling, but no specificity. However, diagnostic specificity of MRI for the knee arthritis associated with the bone erosion and the gouty tophi is high.