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題 名 | Magnetic Resonance Imaging of Tophaceous Gout=痛風性關節炎的磁振造影影像表徵 |
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作 者 | 陳欣琪; 施庭芳; 許昭禹; 陳志榮; 黃國茂; 李瑤華; | 書刊名 | 中華放射線醫學雜誌 |
卷 期 | 24:4 1999.08[民88.08] |
頁 次 | 頁147-152 |
分類號 | 414.925 |
關鍵詞 | 關節炎; 痛風; 磁振造影; Arthritis; Gout; Magnetic resonance; MR; |
語 文 | 英文(English) |
中文摘要 | 痛風性關節炎是一相當常見的疾病,在此疾病的慢性期,常合併出現痛風石。痛風石核心是由單鈉尿酸鹽結晶構成,外圍以不等程度血管分佈的炎性組織。我們回溯分析18個痛風石病灶(16關節),評估這些病灶在磁振造影上的影像表徵。分析結果發現所有的痛風石病灶在T1影像上,都呈現比鄰近的骨骼肌有較低的訊號表現;而在T2影像上,痛風石病灶的訊號表現較具變異性,和鄰近的骨骼肌相比,18個病灶中,12個呈現高訊號表現,6個呈現低訊號表現;有2個關節,可同時觀察到高訊號和低訊號表現的痛風石,發生在關節的不同部位。於T2影像呈現高訊號表現的12個病灶中,有11個病灶可觀察到有極低訊號的點狀物散佈其中。主射顯影劑後,所有T2影像呈現高訊號的12個病灶,都呈現不均勻之顯影加強現象。但病灶內的低訊號點狀物則不顯影。在這12個病灶中,有2個病灶,於注射顯影劑後,可合併觀察到在病灶的其他部位有邊緣顯影加強現象。而於T2影像呈現低訊號的6個病灶,其中4個病灶有接受顯影劑注射檢查,但此4例都缺乏顯影加強現象。藉由這18個病灶的影像分析,我們可以瞭解到,痛風石在T1影像上,均為低訊號表現;而在T2影像上,其訊號表現較具變異性。此外,當痛風石出現顯影加強時,可能與受刺激的關節滑膜及痛風石本身的炎性組織其血管分佈增加有關。 |
英文摘要 | Gouty arthritis is a common disease, and tophi represent the chronic phase of the disease process. A tophus consists of a core of monosodium urate (MSU) crystals surrounded by various degrees of vascularity of inflammatory tissue. We retrospectively reviewed the magnetic resonance (MR) images of 16 joints with tophaceous gout encountered in 14 patients. Totally 18 lesions of tophaceous mass were identified among the 14 patients. The MR images were evaluated for signal intensity characteristics and patterns of enhancement of tophi, and these findings were correlated with pathologic examinations in eight lesions. On T1-wei-hted images, signal intensity of tophi was low when compared with adjacent skeletal muscle in all 18 lesions. The signal intensity of tophi on T2-weighted images was more variable. Twelve of 18 lesions appeared as an area of high signal intensity, and as an area of low signal intensity in 6 of the 18 lesions, compared with adjacent skeletal muscle. Within the T2-weighted high-signal tophi, dot-like low-signal areas on both T1- and T2-weighted images were also noted in 11 of the 12 lesions. On post-enhanced images, all 12 high-signal tophi exhibited moderate, heterogeneous enhancement. In two of these 12, additional marginal enhancement was also noted in different regions of the lesions. Four of the six lesions with T2- weighted low-signal tophi underwent post-enhancement studies and showed poor enhancement in all lesions. The authors conclude that the signal intensity of tophi is constant on T1-but quite variable on T2-weighted and post-enhancement images. The presence of high signal intensity and enhancement could be related to the increased vascularity of adjacent affected synovium and hypervascular granulation tissues within the tophi. |
本系統中英文摘要資訊取自各篇刊載內容。