Graif M, Schweitzer M E, Marks B, Matteucci T, Mandel S
Department of Radiology, Tel Aviv Ichilov-Sourasky Medical Center, Sackler Faculty of Medicine, Israel.
Skeletal Radiol. 1998 May;27(5):262-5. doi: 10.1007/s002560050378.
To improve the present MRI criteria for diagnosis and staging of reflex sympathetic dystrophy (RSD) by including increased joint fluid as an additional MRI sign of RSD.
One hundred and fourteen extremities (69 affected and 45 contralateral controls) in 57 consecutive patients with RSD were evaluated using a 1.5-T unit. T1- and T2-weighted pulse sequences, often with fat suppression, were used before and after administration of intravenous contrast enhancement (Gd). Following T2-weighted image digitization the volume of synovial fluid was measured with a computer model.
Effusions were detected in 61% of the extremities suspected of RSD and in 44% of the contralateral control joints. The mean fluid quantity measured in the symptomatic articulation was 201 mm3. MRI diagnosis of RSD based on previously described criteria was done in 62% of the patients, yielding a sensitivity of 60%. Effusions were present in 79% of the false negative MRI cases. Retrospectively considering the presence of fluid as a potential positive criterion for RSD increases the sensitivity by 31% (to 91%).
Joint effusions are probably associated with early stages of RSD. Adding effusion to the list of radiological criteria for RSD increases the sensitivity of MRI from 60% to 91%.
通过将关节积液增加作为反射性交感神经营养不良（RSD）的一项额外MRI征象，来改进目前用于RSD诊断和分期的MRI标准。
对57例连续性RSD患者的114个肢体（69个患侧和45个对侧对照）使用1.5-T设备进行评估。在静脉注射对比剂（钆）之前和之后，采用T1加权和T2加权脉冲序列，通常加用脂肪抑制。在T2加权图像数字化后，用计算机模型测量滑液体积。
在疑似RSD的肢体中，61%检测到积液，对侧对照关节中44%检测到积液。在有症状关节中测得的平均液体量为201立方毫米。根据先前描述的标准，62%的患者通过MRI诊断为RSD，敏感性为60%。在MRI假阴性病例中，79%存在积液。回顾性地将积液视为RSD的潜在阳性标准可使敏感性提高31%（至91%）。
关节积液可能与RSD的早期阶段相关。将积液添加到RSD的放射学标准列表中可使MRI的敏感性从60%提高到91%。
