膝关节色素沉着绒毛结节性滑膜炎的MRI与病理对照研究  

MRI-Pathologic Correlation of Pigmented Villonodular Synovitis of the Knee Joint

作　　者：马效德[1] 高波[1] 李庆国[1] 李娜[1] 陈颖[1] 李海峰[2] 

机构地区：[1]山东省莱芜市人民医院MRI室,271100 [2]山东省莱芜市人民医院病理科,271100

出　　处：《临床放射学杂志》2002年第9期716-719,共4页Journal of Clinical Radiology

摘　　要：目的　研究膝关节色素沉着绒毛结节性滑膜炎 (PVNS)的MRI表现及其病理基础。资料与方法　回顾性分析 1 8例膝关节PVNS的MRI表现 ,并与手术、病理结果进行对照。结果　PVNS信号强度可分为 3种类型 :Ⅰ型 :T1 WI高信号 ,T2 WI等或高信号 ;Ⅱ型 :T1 WI等或低信号 ,T2 WI低信号 ;Ⅲ型 :T1 WI等或低信号 ,T2 WI高信号。每种类型分别对应其病理发展过程中的早、中及晚期病理表现。 1 8例显示增厚的滑膜、增生的绒毛和结节 ,关节积液有 1 6例 ;1 0例MRI显示关节软骨和骨组织的侵蚀、破坏 ,但术中发现为 1 2例 ;髌下脂肪垫浸润 1 1例 ,术中发现为 9例 ;交叉韧带和半月板受累 2例 ,术中发现有 3例 ;另外累及髌上囊 1 7例 ,内侧关节囊 1 5例 ,外侧关节囊 1 1例 ,后侧关节囊 1 3例。结论　绒毛结节内含铁血黄素沉着所致的T1 WI等或低信号、T2 WI低信号为其特征性表现 ,但其并不贯穿PVNS全过程。Objective To study MRI features and the pathologic basis of pigmented villonodular synovitis (PVNS) of the knee joint.Materials and Methods MRI findings in 18 cases with PVNS of the knee joint were retrospectively analyzed, and a comparison with surgical and pathological results was made.Results The signal intensity of PVNS was divided into 3 types. (1) Type Ⅰ: high signal on T 1WI, intermediate or high signal on T 2WI. (2) Type Ⅱ: intermediate of low signal on T 1WI, low signal on T 2WI. (3) Type Ⅲ: intermediate signal on T 1WI and high signal on T 2WI. Each type respectively corresponded to its early, middle and late pathologic stage of the disease. Thickened synovium, hyperplastic villus and nodules were seen in all cases. Hydrarthrosis was seen in 16 cases, while erosion of articular cartilage and bone in 10 (12 was found during surgery), infiltration of infrapatellar fat pad in 11 (9 was found during surgery), involvement of cruciate ligament and meniscus in 2 (3 was found during surgery). Involvement of suprapatellar bursa was seen in 17, while medial, lateral and posterior part of the articular capsule was affected in 15, 11 and 13 cases, respectively.Conclusion In diagnosing PVNS, MRI is of choice. The intermediate or low signal on T 1WI and low signal on T 2WI, which are produced by hemosiderin deposition within villonodules, is the characteristic sing on MRI, although it does not always appear through the whole course. MRI is of certain value in diagnosing PVNS though the disease carries no specific MRI features.

关 键 词：对照研究 膝关节 滑膜炎 磁共振成像 病理学 

分 类 号：R686.7[医药卫生—骨科学]