MRI影像学特征对膝关节色素沉着绒毛结节性滑膜炎的评价  

MRI evaluation of pigmented villonodular synovitis in the knee joint

作　　者：马树华[1,2] 林飏[1] 程晓玲[1,2] 廖玲敏[1,2] 张龚巍[1,2] 菜泽龙[1,2] 王兆新[3] 

机构地区：[1]汕头大学医学院第一附属医院放射科,广东省汕头市515041 [2]广东省医学分子影像重点实验室,广东省汕头市515041 [3]上海市功能磁共振成像重点实验室(华东师范大学),上海市200026

出　　处：《中国组织工程研究与临床康复》2009年第30期5907-5910,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然科学基金课题(30700235);广东省自然科学基金课题(06301077);广东省卫生厅课题(A2007421);广东省中医药管理局课题(2060134);广东省中医药管理局课题(2008160);汕头市科技局课题(汕府科(2006)85号)资助~~

摘　　要：背景：MRI在膝关节色素沉着绒毛结节性滑膜炎中具有特异性影像征象，并具有极高的临床价值。目的：分析膝关节色素沉着绒毛结节性滑膜炎的MRI影像学特征及诊断价值。设计、时间及地点：单一样本观察，于2007—02／2009-03在汕头大学医学院第一附属医院完成。对象：选择汕头大学医学院第一附属医院骨外科手术病理证实的色素沉着绒毛结节滑膜炎患者15例，男9例，女6例，年龄18-67岁，病程3个月～7年。7例行关节镜下滑膜切除，8例行开放性滑膜切除。方法：采用Philips 1．5T Power 6000MR超导型MRI扫描仪对患者膝关节表面矢状位、冠状位扫描。主要观察指标：色素沉着绒毛结节性滑膜炎患者MRI征象及病理所见。结果：局限型2例，弥漫型13例。色素沉着绒毛结节性滑膜炎主要表现为滑膜不规则结节状增生或弥漫性增生，增生的滑膜内含铁血黄素沉着（T2WI低信号）、邻近半月板和（或）骨侵蚀、关节腔积液等。结论：MRI能为早期诊断膝关节色素沉着绒毛结节性滑膜炎提供依据。BACKGROUND： MRI has a specific imaging sign in pigmented villonodular synovitis （PVNS） in the knee joint and possesses highly clinical value. OBJECTIVE： To analyze the characteristics and diagnostic value of MRI for the PVNS in knee joint. DESIGN, TIME AND SETTING： A single sample survey was performed in the First Affiliated Hospital, Medical College of Shantou University between February 2007 and March 2009. MATERIALS： Fifteen patients of pathologically confirmed PVNS in the knee joint, were recruited from Department of Orthopaedic Surgery in the First Affiliated Hospital, Medical College of Shantou University, including 9 males and 6 females, aged 18 67 years Their course of disease ranged 3 months to 7 years. There were 7 cases underwent arthroscopic synovectomy and 8 cases open synovectomy. METHODS： The knee joint surfaces of the involved patients were scanned with Philips 1.5T Power 6000 MR superconducting MRI scanner in anteroposterior and coronal levels. MAIN OUTCOME MEASURES： MRI sign and pathological changes of PVNS patients. RESULTS： All 15 cases of PVNS involved the knee （2 localized nodulars and 13 diffuse villous）. PVNS was mainly expressed in synovial irregular nodular hyperplasia or diffuse hyperplasia, with hemosiderosis （low signal in T2WI） in proliferative synovial membrane. Meanwhile, the destruction of adjacent meniscus and （or） bone erosion, joint effusion were also be found. CONCLUSION： MRI can provide valuable evidences for the early diagnosis of PVNS.

关 键 词：膝关节 滑膜炎 磁共振成像 

分 类 号：R684[医药卫生—骨科学]