Double-Contrast CT Arthrography in Diagnosis of Chondromalacia Patellae

髕軟骨軟化症－雙重對比關節電腦斷層攝影之診斷

羅煥鉅(Huan-Gui Lou) ； 李瑞華(Jui-Hua Lee) ； 郭光宏(Kuang-Hong Kou) ； 梁鉑鈴(Po-Ling Liang) ； 何善平(Peter S. P. Ho)

《中華放射線醫學雜誌》 15卷3期 (1990/09) Pp. 191-197

摘要

髕軟骨軟化症之傳統X光診斷包括髖骨的位置改變，髕骨向外傾斜(tilting)，股髕關節之早期退化等，但這些X光影像不能直接見到髕軟骨的變化。關節攝影(Arthrogram)雖可看到髕軟骨的變化但常因為許多重疊的影子而造成誤診。雙重對比關節電腦斷層攝影檢查(Double-Contrast CT Arthrography)可克服這些缺點，並直接見到不同層面之髕軟骨，股髕間軟骨(Cartilage of femoral condyle)及股髕關節之關係，對於髕軟骨軟化症可提供快速與方便之診斷工具。髕軟骨軟化症於關節攝影電腦斷層掃描下可見到（一）髕軟骨厚薄不一（二）髕軟骨表面不規則（三）髕軟骨中有顯影劑滯留等三種現象。三軍總醫院骨科部及放射綫部，有16例臨床懷疑有髕軟骨軟化症接受關節攝影電腦斷層檢查；其中二例為正常，其他14例發現有髕軟骨軟化的現象。15例經手術或膝關節鏡檢查證實電腦斷層檢查之發現。本文將介紹此一快速，方便之檢查。

並列摘要

This study was based on 15 cases (16 knees) of computed tomography after double-contrast arthrography of knee in clinically suspected chondromalacia patellae. Fifteen of these 16 knees underwent operation and the result of fourteen agreed with CT findings. In one case, CT imaging could not demonstrate arthroscopic grade I lesion. The CT finding after double contrast arthrography in diagnosis of chondromalacia patellae included:(1) incongruity of cartilage of patella, (2) Irregularity of cartilage of patella and (3) Imbibition of contrast media in the cartilage of patella. We found irregular contour of cartilage of the femoral notch to be present in some cases. All these findings were well demonstrated in our study and correlated with the findings of arthroscopy. We concluded that double-contrast CT arthrograghy can give us an additional way in diagnosis of chondromalacia patellae.

並列關鍵字

Double-contrast CT arthrography ； Chondromalacia patellae