Claudon M, Regent D, Gaucher A, Kessler M, Fabre J L, Grignon B, Netter P
Service de Radiologie-Adultes, Centre Hospitalier Universitaire de Nancy, Vandoeuvre, France.
J Comput Assist Tomogr. 1990 Nov-Dec;14(6):968-74. doi: 10.1097/00004728-199011000-00019.
Ten patients (average age 51 years) on long-term hemodialysis (average duration 13.5 years) were examined by magnetic resonance (MR) (all cases) and CT (five cases) for cystic radiolucencies of the wrist, shoulders, and hips. MR and CT revealed more lesions of smaller size than plain films and both showed a constant communication with the joint space. Synovial hypertrophy was generally absent or very mild even in the case of large osseous erosions. The MR analysis of the content of the lesions in the wrist was quite variable: low signal on T1- and T2-weighted images (12 of 24), low signal on T1- and high signal on T2-weighted images (10 of 24), and high signal on T1- and T2-weighted images (2 of 24). The patterns of transplanted (four cases) or ungrafted (six cases) patients were indistinguishable. These results suggest an articular origin of the lesions, but different from synovial processes such as rheumatoid arthritis, and confirm their probable multifactorial pathogenesis.
对10名长期血液透析(平均病程13.5年)的患者(平均年龄51岁)进行了磁共振成像(MR)(所有病例)和计算机断层扫描(CT)(5例)检查,以观察腕部、肩部和髋部的囊性透亮区。与平片相比,MR和CT发现了更多更小的病变,且二者均显示病变与关节间隙持续相通。即使在存在大的骨质侵蚀的情况下,滑膜增生通常也不存在或非常轻微。腕部病变内容物的MR分析结果差异很大:T1加权像和T2加权像均呈低信号(24例中的12例)、T1加权像呈低信号而T2加权像呈高信号(24例中的10例)、T1加权像和T2加权像均呈高信号(24例中的2例)。移植患者(4例)和未移植患者(6例)的表现没有差异。这些结果提示病变起源于关节,但不同于类风湿关节炎等滑膜病变,并证实其可能为多因素致病机制。