膝关节滑膜囊肿的影像学诊断  

The CT and MRI Features of the Synovial Cyst of the Knee Joints

作　　者：刘旭林[1] 王华[2] 牟仁琪 李淑玲[1] 

机构地区：[1]山东省烟台市烟台山医院影像科,264001 [2]滨州医学院生理教研室

出　　处：《临床放射学杂志》2009年第2期234-237,共4页Journal of Clinical Radiology

摘　　要：目的探讨膝关节滑膜囊肿的CT、MRI表现及诊断价值。资料与方法回顾性分析经手术和病理证实的24例膝关节滑膜囊肿患者的CT(10例)、MRI(24例)资料并记录、分析各种征象。结果囊液呈均匀密度(信号)及明显长T1、长T2信号,无强化。囊壁呈均匀薄膜状中等密度(信号),中度强化。关节囊滑膜疝9例,位于半膜肌与腓肠肌内侧头之间,呈"水滴"状或类圆形,前方以"鸟嘴"状狭颈通关节腔。腓肠-半膜肌滑囊积液9例,亦位于半膜肌与腓肠肌内侧头之间,呈圆形、卵圆形或"葫芦"形,4例与关节腔交通。胫侧副韧带囊肿3例,位于胫侧副韧带走行区,呈卵圆形均质囊性肿物。鹅足腱囊肿3例,位于缝匠肌、股薄肌及半腱肌的联合腱止点与胫骨内侧副韧带之间,呈前后向的扁圆形囊性肿物。手术见各囊肿的位置、形态、大小与关节腔交通情况均与术前CT、MRI结果吻合。合并退变性骨关节炎13例,滑膜骨软骨瘤病3例,慢性膝关节滑膜炎5例,类风湿性关节炎1例,关节软骨损伤10例,半月板损伤11例,半月板退变7例,韧带损伤8例。MRI显示合并的关节内病变与手术结果基本吻合。结论CT、MRI对膝关节滑膜囊肿均可做出正确诊断,但MRI优于CT,能同时发现关节内病变,可指导临床制定合理手术方案。Objective To discuss the CT and MRI features of the synovial cysts of the knee joints and their diagnostic values. Materials and Methods We reviewed retrospectively the CT（ 10 patients） and MRI（24 patients） findings of patients with synovial cysts of the knee joints proved by operations and pathology, and analyzed the features. Results 23 of 24 patients were unilateral, and 1 of 24 was bilateral. The cysts were homogenous both in density and signal. Their CT values were 4 -20 HU, and were hypointense on T1WI and hyperintense on both T2WI and fat-saturated T2 WI. There were no enhancement after intravenous administration of gadopentetate dimeglumine. The walls of cysts were membrane-like, and had the same density and signal as muscle, and had the intermediate enhancement. 9 had herniations of the posterior cysts of the knee joints, and located between the semimembranosus and the medial head of the gastrocnemius. They were of water-dropped and ring-like shape. The fundi which lied posteroinferiorly connected to the joint cavities anteriorly by birdmouth-like narrow necks. 9 had dialatations of gastrocnemius-semimembranosus synovial capsules, which also lied between the semimembranosus and the medial heads of the gastrocnemius, and were round, oval and gourd-like. 4 of them connected to the joint cavities. 3 had nynviol cysts of tibial collateral ligaments, which were oval and homogenous in density. 3 had synovial cysts of anserina,they were oval and lied between the end of conjoined tendon of the sartorius, gracilis and semimembranosus and tibial collateral ligament. The above was proved by the operations. 13 had degenerations of the knee joints, 3 had synovial chondromatosis, 5 had chronic synovial inflammations of the knee joints, 1 had rheumatoid arthritis, 10 had cartilage injuries,ll had meniscus injuries,7 had meniscus degenerations, and 8 had injuries of fibular and tibial collateral ligaments and cruciate ligaments of knees. The MRI findings were coincided with the operations. Conclusion We make the

关 键 词：膝关节 滑膜囊肿 体层摄影术 X线计算机 磁共振成像 

分 类 号：R686[医药卫生—骨科学] R445[医药卫生—外科学]