透析相关性骨关节病课稿.ppt

透析相关性骨关节病 Dialysis Related Osteoarthropathy 骨密度减低,骨小梁模糊及骨骼变形,椎体呈鱼椎样改变,侧弯或后突畸形, 假骨折影, 骨盆入口呈鸡心状或三角形,重者可成三叶状改变 Osteomalacia in a 45-year-old woman with long-standing CRI. Radiograph of the pelvis shows healing fractures (Looser zones) in the pubic rami and right femoral neck (arrowheads) and arthrokatadysis(arrows). 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 一般血液透析只能清除小分子物质，而β2-微球蛋白分子量为11800，为小分子蛋白，血液透析不能有效清除β2-微球蛋白。 Figure 1. MR images of the shoulder in a 46-year-old man with biopsy-proved amyloid protein deposition and chronic shoulder pain. T2*-weighted MR images (not shown) revealed subscapularis tendon thickening. (a) Oblique-coronal T1-weighted turbo spin-echo image (900/12) shows thickening of the supraspinatus tendon (curved arrows) and of the adjacent subdeltoid bursa (arrowheads). There is also a lobulated subchondral bone lesion (straight arrow) exhibiting slight T1 hyperintensity. (b) Corresponding oblique-coronal T2-weighted turbo spin-echo image (3,000/119) shows that the bone lesion (arrowhead) has heterogeneous but predominantly high signal intensity. Thickening of the supraspinatus tendon (arrows) also is seen. 图a 可见增厚的冈上肌腱（白弯箭），信号稍高（黑弯箭），和三角肌下滑囊（白箭），可见略呈分叶状的软骨下骨损伤（黑箭）。 图b T2WI上表现。 Image of minimal erosive arthnitis in a 47-year-old woman with end-stage renal failure, the result of chronic gbomerubonephnitis on maintenance hemodialysis for 13 years. Corner erosions with adjacent calcific deposits (arrows) are present in the lower cervical spine. This was the only patient with spondyloanthropathy who had associated calcium deposits. Similar erosions and calcifications of the fingers discovered 1 year earlier had not progressed on follow up examination. Image of spondyboarthropathy in a 52-year-old woman with polycystic kidney disease. At autopsy, large accu