肩关节滑膜结核的CT、MRI诊断.docVIP

肩关节结核的CT、MRI诊断 CT and MRI diagnosis of shoulder joint tuberculosis 刘国庆 何泽清 刘兴华 王 静 LIU Guoqing HE Zeqing LIU Xinghua WANG Jing 重庆三峡中心医院CT、MR科 （中国 404000） Department of CT and MRI, Chongqing Three Gorges Central Hospital（China 404000） 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。 回顾性分析6例经手术后病理证实为肩关节结核的CT及MRI影像表现特点。 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；肱骨头变形及骨质破坏，可累及肩胛盂；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MRI表现为肩关节周围软组织内单发或多发囊性长T1长T2信号。 CT、MRI检查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。 肩关节；结核；CT；MRI；诊断 AbstractObjective To investigate the image features of shoulder joint tuberculosis by CT and MRI in order to enhance the diagnostic accuracy. Methods Analyze retrospectively the image features by CT and MRI in 6 cases of tuberculosis of shoulder joint, which confirmed by operation and pathology. Results 1 case was bone type tuberculosis accompanied synovial tuberculosis and the CT manifestations were shown as followings: joint space narrowed, head of humerus deformed and destroyed，glenoid cavity involved, bone sclerosis on the edge of bone damaged, soft tissue swelled around the joint and armpit, bone density decreased, and sequestrum scattered . The image features of bone type tuberculosis by MRI were shown as followings: joint space narrowed, head of humerus deformed, the signal of bone destruction showed, soft tissue swelled around the joint and signal abnormal and joint capsule effused. 5 cases were synovial type tuberculosis. The CT manifestations appeared as soft tissue swelling around the shoulder joint and single or multicystic lesions with low density which can communicate each other. MRI showed single or multicystic lesions which had long T1 and long T2 signal in the soft tissue around the shoulder joint. Conclusion The CT and MRI examination could improve the diagnostic accuracy of the tuberculosis of shoulder joint, and had important diagnostic value in them. Key words：sh