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1、髂腰肌囊扩张的影像学表现【摘要】目的探讨髂腰肌囊扩张的CT、MRI表现和诊断价值。方法回顾性阅读经手术病理证实或穿刺抽吸证实的21例髂腰肌囊扩张病人的CT（15例）、MRI（9例）片并记录，分析各种征象。结果21例扩张髂腰肌囊20例发生于单侧，1例发生于双侧。出现于全部或部分髋臼层面上，上下范围2.6-8.5cm，大小为1.0cm×1.2cm～4.2cm×6.3cm，显示为圆形、卵圆形或倒水滴状囊腔，位于髋关节囊前方，髂外或股动静脉外后方和髂腰肌内侧，14例有髂外或股动静脉向前和（或）向内移位，8例髂腰肌内侧有与该囊相应的弧形压迹，12例表面有厚薄不一的肌束覆盖，自
2、上而下逐渐变薄，直至消失，2例沿髋臼向上延伸并突入髂腰肌内，5例延续到髋臼下方，位于耻骨肌前外侧，止于股骨小转子以上。CT扫描均为低密度，CT值为13-42Hu，10例显示薄层囊壁，其余11例囊壁难以显示，6例行CT增强扫描，其中4例囊壁呈细线样轻度强化，9例行MR检查，T1WI呈低信号，T2WI呈水样高信号，呈现为圆形或卵圆形，边缘锐利，沿髂腰肌上下走行。结论CT、MR扫描对髂腰肌囊扩张可做出正确诊断。【关键词】髋关节滑膜囊肿体层摄影术X线计算机磁共振成像[Abstract]ObjectiveTostudytherepresentationsand10diagno
3、sticValueofCTandMRIonenlargediliopsoasbursa.MethodsCTandMRIfilmsof21Patientswithenlargediliopsoasburaswerestudiedretrospectively,Allthesepatientswerepositivelydiagnosedbyaspirationofsynovialfluid,pathloghyorsurgicaloperation.ResultsEnlargediliopsoasbursasinallthe20casesappearedatthelev
4、eloforpartandtheacetabulumsectionsinonlyoneside,and1casesectionsinvolvedindoubleside,rangingfrom2.6cmto8.5cm.Thesizewasfrom1.0cm×1.2cmto4.2cm×6.3cm.Allofthemappearedasround,ovalorupside-down,waterdrop-likecystandlocatedinposterolateraltoexternaliliacbloodvesselsandorfemoralbloodvessels
5、,medialtoiliopsoasmuscle,andanteriortohipjointcapsule.In14cases,externaliliacbloodVessels,andorfemoralbloodvesselswerepushedforwardandorinward.In8cases,therewasanarchedcompressioncorrespondingtothebursainthemedialedgeoftheiliopsoasmuscle.In12cases.thebursasweresurroundedorcoveredbymusc
6、lebundles,whichbecamethinnerandthinnerdownwardsanddisappearedatlast,Thebursasin2casesextendedupwardsalongtheaectabulumandintemalsurfaceoftheiliumbase,protrudingintoiliopsoasmuscle,In5cases,thebursaswentdownwardsandlocatedanterolaterallytopectinealmuscle.OnCTfilms15casesshowedhypodense1
7、0lesionswithCTvaluefrom13-42Hu,In10cases,thethincysticwallwasdemonstrated,whileintheother11cases,itwasdifficulttoidentifythecysticwall.In4outof6casesexaminedwithcontrastenhancedCT,thecysticwalldemonstratedalittleincreaseddensity.In9CasesexaminedbyMRI,enlargediliopsoasbursaappearedasl
