肩关节结核的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(China404000)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、MRI影像诊断表现，旨在提高其诊断准确性。方法凹顾性分析6例经手术后病理证实

2、为启关节结核的CT及MRI影像表现特点。结果1例骨型眉关节结核伴滑膜结核，CT表现为肩关节间隙变窄；肱骨头变形及骨质破坏，可累及启胛盂；破坏边缘伴骨质硬化；肩关节周围及腋窝软组织肿胀，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；周围软组织肿胀及信号异常，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组织肿胀，伴单个或多个囊性低密度影，可相互沟通；MRI表现为肩关节周用软组织内单发或多发囊性长T1长T2信号。结论CT、MRI检杳可提高肩关节结核的诊断准确率，在诊断肩关节结核方面具有重要价值。关键词：肩关节；结核；C

3、T；MRI；诊断AbstractObjectiveToinvestigatetheimagefeaturesofshoulderjointtuberculosisbyCTandMRIinordertoenhancethediagnosticaccuracy.MethodsAnalyzeretrospectivelytheimagefeaturesbyCTandMRIin6easesoftuberculosisofshoulderjoint,whichconfirmedbyoperationandpathology.Results1casewasbonetypetuberculos

4、isaccompaniedsynovialtuberculosisandtheCTmanifestationswereshownasfollowings:jointspacenarrowed,headofhumerusdeformedanddestroyed,glenoidcavityinvolved,bonesclerosisontheedgeofbonedamaged,softtissueswelledaroundthejointandarmpit,bonedensitydecreased,andsequestrumscattered.Theimagefeaturesofbo

5、netypetuberculosisbyMRIwereshownasfollowings:jointspacenanowed,headofhumerusdeformed,thesignalofbonedestructionshowed,softtissueswelledaroundthejointandsignalabnormalandjointcapsuleeffused・5casesweresynovialtypetuberculosis.TheCTmanifestationsappearedassofttissueswellingaroundtheshoulderjoint

6、andsingleormulticysticlesionswithlowdensitywhichcancommunicateeachother.MRIshowedsingleormulticysticlesionswhichhadlongT】andlongT2signalinthesofttissuearoundtheshoulderjoint.ConclusionTheCTandMRIexaminationcouldimprovethediagnosticaccuracyofthetuberculosisofshoulderjoint,andhadimportantdiagno

7、sticvaluein(hem.Keywords：shoulderjoint;tuberculosis;computedtomography;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骨型。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例肩关节结核