【摘要】 目的探讨色素沉着绒毛结节性滑膜炎(PVNS)病理表现及磁共振成像(MRI)特点,分析MRI的诊断价值。方法对16例MRI检查并经手术病理检查或关节镜活检证实为PVNS患者的临床资料进行分析总结。结果 16例患者均为单发,均为膝关节。MRI表现为弥散型滑膜增厚12例,局灶型滑膜增厚4例。增厚的滑膜T1WI呈等信号9例,稍高信号3例,低信号4例;T2WI呈高信号2例,高、低混杂信号14例,其中T2W I低信号显示更为明显。8例膝关节增生者滑膜突破关节囊进入腘窝,形成多发大小不等结节状异常信号。髌上囊滑膜边缘呈波浪状改变12例,髌下脂肪囊见结节状、片状异常信号10例,前后交叉韧带区见混杂信号影4例,出现骨质侵蚀性改变10例。3例增强扫描者均呈中度至明显增强。16例患者膝关节病变均伴关节积液,其中4例积液可见T2低信号结节。结论 PVNS病理及MRI表现具有特征性,MRI在PVNS的诊断与鉴别诊断方面具有重要价值。更多还原

【Abstract】 Objective To explore the pathological expression of pigmented villonodular synovitis(PVNS) and characteristics of magnetic resonance imaging(MRI),and analyze the diagnosis value of MRI. Methods Clinical data of 16 patients,who diagnosed as PVNS by MRI examination and pathological examination or arthroscopy biopsy,were analyzed and summarized. Results All the 16 patients were with single shot appeared in knee joint. MRI showed that 12 case were with diffused synovial thickening and the other 4 cases were with focal synovial thickening. On T1WI of the synovial thickening,9 cases had uniform signal,3 cases had slightly higher signal and 4 cases had low signal;while on T2WI,2 cases had higher signal and 14 cases had mixed signals. The low signal on T2WI was obviously. The proliferative synovial membrane appeared nodular of different size with abnormal signal,invading popliteal fossa through joint capsule in 8 cases. The synovial membrane of suprapatellar bursa showed wavy in 12 cases. Nodular and patchy abnormal signal were seen in infrapatellar bursa in 10 cases. Mixed signal intensity were seen beside anterior and posterior cruciate ligament in 4 cases. Bone erosion was seen in 10 cases. With contrast,the lesions were moderately or markedly enhanced in 3 cases. Knee joint effusion was seen in all of the cases,and low signal of T2 could be seen in 4 cases of effusion. Conclusion PVNS pathology and MRI expression have characteristic manifestation,and MRI has important value in diagnosis and differential diagnosis of PVNS.更多还原