Malta Luis Marcelo de Azevedo, Lugon Jocemir Ronaldo, Dos Santos Alair Augusto Sarmet Moreira Damas, Machado Leonardo Martins
School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
Radiol Bras. 2022 Sep-Oct;55(5):293-298. doi: 10.1590/0100-3984.2021.0144.
To evaluate the knees of individuals with renal failure who are on hemodialysis, using magnetic resonance imaging (MRI), comparing them with those of a group of individuals with normal renal function.
This was a cross-sectional, observational, controlled study conducted between August 2018 and February 2020. The cases consisted of 15 patients who had been on hemodialysis for ≥ 5 years and did not have a quadriceps tendon rupture. The controls consisted of 15 individuals with normal renal function who were matched (1:1) to the cases for sex, age, and physical activity level. The subjects in both groups underwent MRI of the right knee only.
The mean ages of the cases and controls were 50 ± 15 years and 49 ± 14 years, respectively. The median time on hemodialysis was 11 years (range, 10-14 years). Serum levels of parathyroid hormone, ferritin, alkaline phosphatase, phosphorus, and creatinine were higher among the cases than among the controls, whereas serum albumin and hemoglobin were lower ( < 0.05 for all). The MRI study showed a hyperintense signal in the quadriceps tendon in 11 of the cases and in three of the controls ( = 0.009). Knee joint effusion was observed in nine of the cases and in three of the controls ( < 0.05). The thickness, length, and width of the tendon did not differ between the groups. A hyperintense signal in the tendon was not associated with the time on hemodialysis; nor with the levels of intact parathyroid hormone, hemoglobin, or alkaline phosphatase.
Patients on chronic hemodialysis, even those without a tendon rupture, show a hyperintense signal in the quadriceps tendon on MRI.
使用磁共振成像（MRI）评估接受血液透析的肾衰竭患者的膝关节，并与一组肾功能正常的个体进行比较。
这是一项于2018年8月至2020年2月进行的横断面、观察性、对照研究。病例组包括15例接受血液透析≥5年且无股四头肌肌腱断裂的患者。对照组包括15例肾功能正常的个体，在性别、年龄和身体活动水平方面与病例组进行了1:1匹配。两组受试者均仅对右膝进行了MRI检查。
病例组和对照组的平均年龄分别为50±15岁和49±14岁。血液透析的中位时间为11年（范围为10 - 14年）。病例组的甲状旁腺激素、铁蛋白、碱性磷酸酶、磷和肌酐的血清水平高于对照组，而血清白蛋白和血红蛋白水平较低（所有均P<0.05）。MRI研究显示，11例病例的股四头肌肌腱出现高信号，3例对照组出现高信号（P = 0.009）。9例病例和3例对照组观察到膝关节积液（P<0.05）。两组之间肌腱的厚度、长度和宽度无差异。肌腱中的高信号与血液透析时间无关；也与完整甲状旁腺激素、血红蛋白或碱性磷酸酶水平无关。
慢性血液透析患者，即使是那些没有肌腱断裂的患者，在MRI上股四头肌肌腱也显示出高信号。
