磁共振成像鉴别复发性多软骨炎与耳廓软骨膜炎1例报告并文献复习
Differentiation of Relapsing Polychondritis and Auricular Perichondritis by Magnetic Resonance Imaging: A Case Report and Literature Review
摘要: 复发性多软骨炎(Relapsing Polychondritis, RP)是一种以免疫介导为特征的系统性炎症性疾病,耳软骨炎是RP最具特征性的临床表现之一。耳廓软骨膜炎(Auricular Perichondritis)临床上表现为耳廓红肿疼痛,可伴有脓肿形成。当RP初期临床症状仅表现于耳部时,RP与耳廓软骨膜炎不易进行鉴别。磁共振成像(Magnetic Resonance Imaging, MRI)具有优异的软组织分辨率和多参数成像能力。本文报告1例通过磁共振成像鉴别复发性多软骨炎与耳廓软骨膜炎的临床资料,复习国内外相关文献,探讨MRI在RP与耳廓软骨膜炎鉴别诊断中的应用价值。
Abstract: Relapsing Polychondritis (RP) is a systemic inflammatory disorder characterized by immune-mediated cartilage destruction, with auricular chondritis being one of its most distinctive clinical manifestations. In contrast, auricular perichondritis typically presents with erythema, swelling, and pain of the auricle, potentially progressing to abscess formation. Early-stage RP with isolated auricular involvement can be clinically indistinguishable from auricular perichondritis, posing diagnostic challenges. Magnetic Resonance Imaging (MRI), leveraging its exceptional soft-tissue resolution and multiparametric imaging capabilities, provides critical insights into cartilage-specific inflammatory patterns. This article presents a case in which MRI effectively differentiated RP from auricular perichondritis, underscoring its diagnostic utility in clinical practice. A literature review further explores the role of MRI in delineating these two entities based on characteristic imaging biomarkers.
文章引用:吴颖慧, 梁宏达. 磁共振成像鉴别复发性多软骨炎与耳廓软骨膜炎1例报告并文献复习[J]. 临床医学进展, 2025, 15(4): 1211-1216. https://doi.org/10.12677/acm.2025.1541048

参考文献

[1] 徐健, 王丹丹, 石桂秀, 等. 复发性多软骨炎诊疗规范[J]. 中华内科杂志, 2022, 61(5): 525-530.
[2] Davidi, E., Paz, A., Duchman, H., Luntz, M. and Potasman, I. (2011) Perichondritis of the Auricle: Analysis of 114 Cases. The Israel Medical Association Journal, 13, 21-24.
[3] Hansson, A., Heinegård, D., Piette, J., Burkhardt, H. and Holmdahl, R. (2001) The Occurrence of Autoantibodies to Matrilin 1 Reflects a Tissue-Specific Response to Cartilage of the Respiratory Tract in Patients with Relapsing Polychondritis. Arthritis & Rheumatism, 44, 2402-2412. [Google Scholar] [CrossRef
[4] Foidart, J., Abe, S., Martin, G.R., Zizic, T.M., Barnett, E.V., Lawley, T.J., et al. (1978) Antibodies to Type II Collagen in Relapsing Polychondritis. New England Journal of Medicine, 299, 1203-1207. [Google Scholar] [CrossRef] [PubMed]
[5] Mcadam, L.P., OʼHanlan, M.A., Bluestone, R. and Pearson, C.M. (1976) Relapsing Polychondritis: Prospective Study of 23 Patients and a Review of the Literature. Medicine, 55, 193-215. [Google Scholar] [CrossRef
[6] Damiani, J.M. and Levine, H.L. (1979) Relapsing Polychondritis—Report of Ten Cases. The Laryngoscope, 89, 929-946. [Google Scholar] [CrossRef
[7] Lin, D., Yang, W., Zhang, P., Lv, Q., Jin, O. and Gu, J. (2016) Clinical and Prognostic Characteristics of 158 Cases of Relapsing Polychondritis in China and Review of the Literature. Rheumatology International, 36, 1003-1009. [Google Scholar] [CrossRef] [PubMed]
[8] Kempta Lekpa, F., Piette, J.C., Bastuji-Garin, S., et al. (2010) Serum Cartilage Oligomeric Matrix Protein (COMP) Level Is a Marker of Disease Activity in Relapsing Polychondritis. Clinical and Experimental Rheumatology, 28, 553-555.
[9] Mertz, P., Costedoat-Chalumeau, N., Ferrada, M.A., Moulis, G., Mekinian, A., Grayson, P.C., et al. (2024) Relapsing Polychondritis: Clinical Updates and New Differential Diagnoses. Nature Reviews Rheumatology, 20, 347-360. [Google Scholar] [CrossRef] [PubMed]
[10] 李延婷, 王紫霄, 何夏秀. 误诊类风湿关节炎的复发性多软骨炎一例[J]. 中华临床免疫和变态反应杂志, 2018, 12(1): 34-36.
[11] 方玉婷, 徐丽萍. 首诊于耳鼻咽喉科的复发性多软骨炎临床特征分析[J]. 中国耳鼻咽喉头颈外科, 2017, 24(8): 433-434.
[12] 郑仕钰, 郑在勇, 王洁, 廖艳, 许琼, 刘世平. 复发性多软骨炎的诊治进展[J]. 风湿病与关节炎, 2022, 11(6): 72-76.
[13] 陈烨颖, 潘小环, 关玉宝, 杨新官, 刘海平, 陈萍. 18F-FDG PET/CT诊断复发性多软骨炎[J]. 中国医学影像技术, 2019, 35(1): 138-142.
[14] 苏玉玲. 18F-FDG PET/CT显像结束后对周围人群的辐射研究[J]. 中国辐射卫生, 2020, 29(3): 257-259.
[15] Vitale, A., Sota, J., Rigante, D., Lopalco, G., Molinaro, F., Messina, M., et al. (2015) Relapsing Polychondritis: An Update on Pathogenesis, Clinical Features, Diagnostic Tools, and Therapeutic Perspectives. Current Rheumatology Reports, 18, Article No. 3. [Google Scholar] [CrossRef] [PubMed]
[16] Valesini, G., Iannuccelli, C., Marocchi, E., Pascoli, L., Scalzi, V. and Di Franco, M. (2007) Biological and Clinical Effects of Anti-TNFα Treatment. Autoimmunity Reviews, 7, 35-41. [Google Scholar] [CrossRef] [PubMed]
[17] Prasad, H.K.C., Sreedharan, S., Prasad, H.S.C., Meyyappan, M.H. and Harsha, K.S. (2007) Perichondritis of the Auricle and Its Management. The Journal of Laryngology & Otology, 121, 530-534. [Google Scholar] [CrossRef] [PubMed]
[18] 郑铨艺, 柯朝阳, 龚桃根, 吕颜露, 鄢敏. 中耳手术后并发化脓性耳廓软骨膜炎的治疗[J]. 中华耳科学杂志, 2017, 15(3): 317-320.