浅析色素沉着绒毛结节性滑膜炎的影像学诊断  

Imaging diagnosis of pigmented villonodular sonorities

作　　者：赵永峰[1] 田忠祥[1] 王丹[1] 王晓娣[1] 

机构地区：[1]武警江苏总队南京医院影像科,江苏南京210028

出　　处：《中国现代医学杂志》2013年第3期79-82,共4页China Journal of Modern Medicine

摘　　要：目的探讨色素沉着绒毛结节性滑膜炎(PVNS)的影像学特征性表现,以提高对该病的影像学诊断水平及鉴别诊断的能力。方法回顾性分析14例疑为PVNS病例中11例经病理证实的PVNS影像学特点并进行总结分析。11例中9例行X线DR检查,其中1例同时行关节空气造影检查;CT平扫5例;7例行MRI检查,其中2例行增强扫描。结果 11例均为单关节发病,其中膝关节7例、踝关节2例、髋关节1例、腕关节1例。主要影像学表现为:①关节囊肿胀及结节状软组织肿块:11例均显示关节囊肿胀,4例X线平片(44.4%)、4例CT(80%)及7例MR(I100%)显示结节状软组织肿块;②软骨下边缘清楚的骨质侵蚀及硬化缘6例:其中X线显示2例、CT显示4例、MRI显示5例;③滑膜增厚10例:CT显示4例(80%)、MRI显示7例(100%)。其中弥漫性增厚8例,单纯局限性增厚2例;④关节腔积液及关节间隙的改变:关节腔积液9例(81.8%),关节间隙狭窄4例(36.4%);⑤多发结节的MRI信号改变:结节均呈长T1短T2信号者4例;信号混杂者2例;另1例既有长T1长T2信号,也有长T1短T2信号。结论 PVNS的影像学表现具有一定的特征性,影像学检查特别是MRI扫描能够做出正确诊断。[ Objective ] To explore the imaging appearance of pigmented villonodular synovitis （PVNS） to improve the levels of imaging diagnosis and differential diagnosis of PVNS. [ Methods ] Imaging data of 11 patients with PVNS confirmed by pathology were analyzed retrospectively. Among them, 9 patients were examined by routine X- ray DR （1 combined with joint air contrast examination）, 5 by CT scanning, and 7 by MRI （2 combined with en- hancement scanning）. [Results] All 11 patients are belonged simple joint disease, including 7 in knee, 2 in ankle joint, 1 in the hip, and 1 in wrist joint. The main imaging findings are as follows： ① Swelled articular capsule were showed in all 11 patients, and nodular soft-tissue tumor showed respectively in 4 cases （44.4%） with X-ray plain film, 4 （80%） with CT, and 7 with MRI （100%）.②There were 6 patients displayed bone erosion and sclerotic margin with subehondral clear margin, in which 2 showed by X-ray, 4 by CT, and 5 by MRI. ③There were 10 patients dis- played synovium thickening, including 8 cases of diffuse thickening and 2 simple localized thickening, in which 4 （80%） showed by CT, and 7（100%） by MRI. ④Nine cases（81.8%） of arthroedema and 4 cases（36.4%） of joint space stenosis were displayed. （~）MRI signal changes of multiple nodules were revealed, including 4 cases with long T1 and short T2 signals, 2 with mixed signals, and the other 1 combined long T1 and long T2 signals with long T1 and short T2 signals. [Condusion ] PVNS has some special imaging appearance, and imaging examinations, especially the MRI scan, can make correct diagnosis.

关 键 词：关节滑膜炎 含铁血黄素 影像 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]