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结晶性关节炎的影像学研究。

Imaging studies of crystalline arthritides.

作者信息

Paparo F, Fabbro E, Ferrero G, Piccazzo R, Revelli M, Camellino D, Garlaschi G, Cimmino M A

机构信息

Department of Radiology, E.O. Ospedali Galliera, Genoa, Italy.

出版信息

Reumatismo. 2012 Jan 19;63(4):263-75. doi: 10.4081/reumatismo.2011.263.

Abstract

Gout, calcium pyrophosphate dihydrate (CPPD) deposition disease, and calcium hydroxyapatite deposition disease (HADD) are the three most common crystal-induced arthropathies. Multimodality imaging may help in their diagnosis, and is useful for a precise and comprehensive assessment and grading of the related osteoarticular damage. Plain film radiography, due to its low cost and wide availability, is the first imaging technique to be used in crystal deposition diseases, providing well-known and specific findings for CPPD deposition disease and HADD, while it may undergrade the early osteoarticular lesions in gouty patients. Ultrasonography (US) is a radiation-free approach that accurately depicts crystal deposits in cartilage, peri- and intra-articular soft tissues, but it does not give a panoramic view of the affected joints. Cross-sectional imaging techniques can examine crystal deposits in the spine and axial joints. CT has the potential to distinguish monosodium urate (MSU) crystals from calcium containing crystals, due to their different attenuation values. MRI may demonstrate synovitis, erosions and bone marrow edema in gouty patients and it may differentiate tophi from other soft tissue nodules due to its high contrast resolution and power of tissue characterization.

摘要

痛风、二水焦磷酸钙(CPPD)沉积病和羟基磷灰石沉积病(HADD)是三种最常见的晶体性关节炎。多模态成像有助于其诊断,对于相关骨关节损伤的精确全面评估及分级很有用。平片摄影因其成本低且普及性高,是晶体沉积病首选的成像技术,能提供CPPD沉积病和HADD的典型特征性表现,不过可能会低估痛风患者早期的骨关节病变。超声检查(US)是一种无辐射的方法,能准确显示软骨、关节周围及关节内软组织中的晶体沉积,但无法全面观察受累关节。断层成像技术可检查脊柱和轴关节中的晶体沉积。由于尿酸钠(MSU)晶体和含钙晶体的衰减值不同,CT有区分二者的潜力。MRI可显示痛风患者的滑膜炎、侵蚀及骨髓水肿,因其高对比度分辨率和组织特征分辨能力,还可区分痛风石与其他软组织结节。

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