滑膜软骨瘤病MRI与病理对照分析  

The correlation between MRI and pathologic findings of synovial chondromatosis

作　　者：张刚[1] 沈比先[1] 谢井文[1] 刘翰林[1] 张大波[1] 

机构地区：[1]广东医学院附属南山医院放射科,广东深圳518052

出　　处：《医学影像学杂志》2010年第10期1524-1526,共3页Journal of Medical Imaging

摘　　要：目的:研究滑膜软骨瘤病的MRI表现及其与病理变化之间的联系。方法:回顾性分析经手术病理证实的12例滑膜软骨瘤病的MRI表现和病理变化。结果:①MRI表现:所有12例关节滑膜均增厚,其中3例增强扫描者滑膜明显强化;滑膜软骨瘤病结节呈现五种信号表现:1型.与骨骼肌相比呈均匀的长T1长T2信号;2型.在所有脉冲序列呈均匀低信号;3型.低信号的结节中心为高信号;4型.与3类似,但在高信号区内散在点状低信号;5型.黄骨髓信号。X线不能显示1型结节,增强扫描者滑膜软骨瘤病结节无强化。3例病变邻近骨质出现外压性侵蚀;②病理变化:大体病理可见增厚的滑膜表面有多发的结节状突起;显微镜下可见滑膜软骨瘤病结节主要有以下特点:可见结节状的透明软骨,结节部分区域被覆纤维组织层;软骨结节中见软骨细胞,软骨结节部分区域钙化和骨化。结论:MRI能准确的反映滑膜软骨瘤病的病理变化,对该病有很高的诊断价值。Objective：To study the correlation between MRI and pathologic findings of synovial chondromatosis.Methods：The MRI features and the pathologic findings of 12 patients with synovial chondromatosis confirmed by operation and pathology were reviewed.Results：① MRI features： thickened synovial were seen in all 12 cases,obviously enhancement of synovial were seen in 3 contrast-enhanced cases;we found five types signal of chondromatosis nodules： type 1,homogeneous low signal intensity to that of muscle on T1WI and high on T2WI;type 2,hypointense on all pules senquences;type 3,hyperintense area in the center of hypointense nodules;type 4,similar to type 3（but punctiform hypointense were seen in the hyperintense center）,and type 5,signal of yellow bone marrow.Radiographs can not reveal nodules of type 1,extrinsic erosion of bone were seen in 3 cases;② Pathologic features： the gross pathologic apperanced of synovial chondromatosis consists of hyperplastic synovium covering projections;at microscopic analysis,nodous hyaline cartilage surrounded by fibrous tissue were seen,chondrocytes,calcification and ossification were seen in the nodule.Conclusion：MRI can reflect the pathologic changs of synovial chondromatosis and have high diagnostic value.

关 键 词：滑膜软骨瘤病 磁共振成像 病理 

分 类 号：R738.5[医药卫生—肿瘤] R445.2[医药卫生—临床医学]