肩关节滑膜结核的CT、MRI诊断

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1、肩关节结核的CT、MRI诊断CTandMRIdiagnosisofshoulderjointtuberculosis刘国庆何泽清刘兴华王静LIUGuoqingHEZeqingLIUXinghuaWANGJing重庆三峡中心医院CT、MR科(中国404000)DepartmentofCTandMRI,ChongqingThreeGorgesCentralHospital(China4040(X))中图分类号：R816.8文献标识码：A文章编号：1818—0086(2011)04摘要：目的探讨肩关节结核的CT、MR1影像

2、诊断表现，旨在提高其诊断准确性。方法回顾性分析6例经手术后病理证实为启关节结核的CT及MRI影像表现特点。结果1例骨型肩关节结核伴滑膜结核，CT表现为肩关节间隙变窄；肱骨头变形及忖质破坏，可累及肩胛盂；破坏边缘伴骨质硬化；肩关节周国及腋禽软组织肿胀，密度减低，伴散在死骨形成。骨型肩关节结核MRI表现为肩关节间隙变窄：肱骨头变形，其内骨质破坏异常信号；周田软组织肿胀及信号界常，关节囊积液。5例滑膜型肩关节结核，CT表现为肩关节周围软纟II织肿胀，伴单个或多个囊性低密度影，可相互沟通；MR1衣现为肩关节周围软组织内单发或

3、多发囊性长T1长T2信号。结论CT、MRI检查对提高启关节结核的诊断准确率，在诊断肩关节结核方而具有重要价值。关键词：肩关节；结核；CT；MR1；诊断AbstractObjectiveToinvestigatetheimagefeaturesofshoulderjointtuberculosisbyCTandMRIinordertoenhancethediagnosticaccuracy.MethodsAnalyzeretrospectivelytheimagefeaturesbyCTandMRIin6casesof

4、tuberculosisofshoulderjoint,whichconfirmedbyoperationandpathology.Results1casewasbonetypetuberculosisaccompaniedsynovialtuberculosisandtheCTmanifestationswereshownasfollowings:jointspacenarrowed,headofhumetusdeformedanddestroyedglenoidcavityinvolved,bonescleros

5、isontheedgeofbonedamaged,softtissueswelledaroundthejointandarmpit,bonedensitydecreased,andsequestrumscattered•TheimagefeaturesofbonetypetuberculosisbyMRIwereshownasfollowings:jointspacenarrowed,headofhumerusdeformed,thesignalofbonedestructionshowed,softtissuesw

6、elledaroundthejointandsignalabnormalandjointcapsuleeffused.5casesweresynovialtypetuberculosis.TheCTmanifestationsappearedassofttissueswellingaroundtheshoulderjointandsingleormulticysticlesionswithlowdensitywhichcancommunicateeachother.MRIshowedsingleormulticyst

7、iclesionswhichhadlongTiandlongT?signalinthesofttissuearoundtheshoulderjoint.ConclusionTheCTandMRIexaminationcouldimprovethediagnosticaccuracyofthetuberculosisofshoulderjoint,andhadimportantdiagnosticvalueinthem.Keywords：shoulderjoint;tuberculosis;computedtomogr

8、aphy;magneticresonanceimaging;diagnosis肩关节不同于其它关节，感染结核的机率相对较少，故临床上非常少见。临床上将肩关节结核分为滑膜型及竹型。据文献统计国内仅报告儿十例，绝人多数为治疗情况，少数为普通X线表现，无相关的CT、MRI影像资料。本文对我院2008年1月〜2010年10月经手术、病理证实的6例肩关节