色素沉着绒毛结节性滑膜炎的MRI诊断及随访评价

目的评价MRI在色素沉着绒毛结节性滑膜炎(PVNS)术前诊断和鉴别诊断、治疗效果及术后随访的作用。方法回顾性分析2003年1月到2011年1月在本组临床疑诊为大关节PVNS患者的临床及影像学资料,并与关节镜或手术病理进行比较,分析PVNS的MRI影像特点、诊断正确率、误漏诊原因,以及在术后随访及复发的鉴别诊断价值。结果 66例患者的资料纳入分析,54例经过病理确诊为PVNS,男23例,女31例。其中弥漫型为46例,局限型为8例。MRI诊断为PVNS55例,52例确诊为PVNS,MRI诊断PVNS准确率78.8%;术后复发20例,MRI诊断复发准确率100%;7例术后联合放射治疗,1例放疗后病理性骨折。结论 PVNS是一个容易复发的良性滑膜增生性疾病,MRI术前及术后诊断准确率高,MRI在术后随访中具有重要的意义。

MRI diagnosis and follow-up study of pigmented villonodular synovitis

Objective To analysis the accuracy of MRI diagnosing pigmented villonodular synovitis preoperatively and its role in follow-up. Methods A retrospective analysis study was carried out from January 2003 to January 2011, which invovled clinical-suspected pigmented villonodular synovitis patients. Pathological findings, age, joint distribution, treatment, preoperative and postoperative imaging findings were all analyzed and compared. Results 66 patients were included, among which 54 cases of 23 men and 31 women were pathologically proved as PVNS. 46 cases were diffused type and eight cases were localized type. There were 52 cases of PVNS diagnosed by MRI correctly; MRI preoperative diagnosis accuracy was 78. 8%. 20 cases recurred, of which MRI diagnostic accuracy rate was 100%. Seven cases were applied postoperative radiotherapy and one of these cases was found pathological fracture after radiotherapy. Conclusions Pigmented villonodular synovitis is a benign proliferating disease which often relapses; preoperative and postoperative MRI diagnostic accuracy rate is high and MRI may play an important role in follow-up.