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1、428中华放射学杂志2003年5月第37卷第5期ChinJRadiol,May2003,Vol37,No.5骨骼肌肉系统放射学Charcot关节的影像表现孟悛非周春香陈应明江波摘要!目的探讨Charcot关节的MRI表现,评价X线片、CT及MRI对Charcot关节的诊断价值。方法对8例Charcot关节作X线、CT及MR检查,其中6例患有脊髓空洞症,1例为胸髓损伤截瘫患者,1例为糖尿病患者,所有8例均有患肢的痛觉减退或消失。结果(1)Charcot关节表现为增生和吸收2型。(2)X线及CT特点:3例增生型关节骨质增生硬化、骨赘形成,关节周围软组织肿
2、胀,内见大量块状骨化影;5例吸收型关节以骨质破坏吸收、碎裂为主,骨端消失,其中3例残端平齐如手术切除,周围软组织肿胀,内见多个小而锐利的骨化影。8例中有3例伴有关节半脱位。(3)主要MRI特点:8例均清楚显示关节周围软组织块影结构,7例分为3层:由内向外为关节囊内积液、关节囊壁及囊壁外其余软组织块影,1例关节囊壁与其外软组织块影分界不清,表现为2层结构。关节囊壁不均匀增厚、松弛及拉长,在关节周围、骨干旁或肌间隙内呈伪足状伸延,T1WI呈稍低信号,T2WI呈稍高信号,注射钆喷替酸葡甲胺(GdDTPA)后明显强化,其强化程度常高于外周的软组织块影。关节周围软组织块影的3层结构
3、及关节囊的改变较具特点。结论X线片是Charcot关节的首选诊断手段,MRI在Charcot关节的诊断及鉴别诊断方面是X线片重要的补充手段。关键词!骨;关节病,神经源性;磁共振成像ImagingfindingsofCharcotjointMENGQuanfei,ZHOUChunxiang,CHENYingming,JIANGBo.DepartmentofRadiology,FirstAffiliatedHospital,SunYatSenUniversity,Guangzhou510080,ChinaAbstract!ObjectiveToanalyz
4、etheMRIcharactersofCharcotjoint,andtoevaluatethediagnosticvalueofXray,CT,andMRIonCharcotjoint.MethodsEightpatientswith8CharcotjointsunderwentXray,CT,andMRexaminations.6ofthemhadsyringomyelia,1patienthadinjuryofthespinalcord,and1casehaddiabetes.All8patientshadsensoryreductionordeficitint
5、hesickextremities.ResultsThereweretwotypesofCharcotjoint,hypertrophicandatrophic.RadiographicandCTfeaturesofhypertrophicjoint(n=3)showedhyperostoticosteosclerosisandmammothosteophytesinthesickbones,periarticularossification,andarticulardisorganization.RadiographicandCTfeaturesofatrophicjo
6、int(n=5)showedextensiveboneresorption(destruction),periarticulardebris,andarticulardisorganization.MainMRIfeaturesofCharcotjointincludedhydrarthrosiswithinjointcapsule,thickened,loose,andelongatedjointcapsulewithparajoint,peridiaphysis,andintermuscularextensioninapseudopodiapattern.Thei
7、rregularjointcapsulewallwaspresentedasmildhypointensityonT1WI,slighthyperintensityonT2WI,andwasmarkedlyenhancedafterGdDTPAwasadministrated,whichwasconsideredasacharacteristicmanifestationofthelesion.SofttissuemasscontaininghypointensestripesonbothT1WIandT2W
