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肩部动脉假性动脉瘤误诊为其他疾病:利用肌肉骨骼磁共振成像中的搏动伪影对2例患者进行准确诊断

Arterial pseudoaneurysms of the shoulder mimicking other entities: utilization of pulsation artifact on musculoskeletal MR for accurate diagnosis in 2 cases.

作者信息

Samim Mohammad, Mandell Jacob, Smith Stacy, Kapoor Neena, Czuczman Gregory

机构信息

Department of Radiology, Hospital for Joint Disease, New York University, 301st 17th Street. Rm 600, New York, NY, 10003, USA.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.

出版信息

Skeletal Radiol. 2017 Aug;46(8):1119-1124. doi: 10.1007/s00256-017-2622-9. Epub 2017 Mar 18.

Abstract

We present two cases of pseudoaneurysm (PSA) about the shoulder mimicking more common clinical entities-soft tissue neoplasm and septic arthritis-for which biopsy of the mass and joint aspiration were requested respectively. We review the imaging findings of PSA with emphasis on findings in musculoskeletal protocol MRI, including the identification of pulsation artifact in both cases, which was critical to establishing the correct diagnosis. In the proper clinical setting, with imaging findings demonstrating a complex mass or fluid collection, MR images should be scrutinized for the presence of pulsation artifact, which can help diagnose a high-flow vascular lesion and avoid a potentially harmful invasive procedure such as biopsy.

摘要

我们报告了两例肩部假性动脉瘤(PSA)病例,它们分别酷似更常见的临床病症——软组织肿瘤和化脓性关节炎,为此分别对肿块进行了活检并对关节进行了穿刺抽吸。我们回顾了PSA的影像学表现,重点是肌肉骨骼检查方案MRI的表现,包括两例病例中搏动伪影的识别,这对确立正确诊断至关重要。在适当的临床环境中,当影像学表现显示为复杂肿块或液体积聚时,应仔细检查MR图像中是否存在搏动伪影,这有助于诊断高流量血管病变并避免诸如活检等潜在有害的侵入性操作。

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