膝关节树枝状脂肪瘤与慢性滑膜炎脂肪增生的MRI和病理表现

目的研究膝关节树枝状脂肪瘤(LA)的磁共振特征表现,结合影像病理探讨膝关节LA与慢性滑膜炎脂肪增生存在的联系。材料与方法回顾性分析14例膝关节滑膜病变,其中4例诊断LA,10例诊断慢性滑膜炎伴滑膜脂肪增生。所有病例均行病灶切除术,制作成病理标本,行HE染色。结果 14例中4例确诊LA的MRI及病理表现呈叶状、树枝状、乳头状的脂肪组织,轻度的滑膜增生,其中2例除了看到明显成团大量成熟的脂肪细胞,还可以见散在的点絮状的脂肪组织;10例确诊慢性滑膜炎脂肪增生MRI表现与病理上表现明显增生的滑膜组织、少量散在的脂肪细胞,部分较少量脂肪在MRI上观察不到。二者均可以伴随膝关节炎性、退行性改变。结论本研究表明LA与慢性滑膜炎脂肪增生在影像及病理均表现为关节下滑膜脂肪细胞的增生,而不同之处在于滑膜下脂肪的形态以及含量。推测LA与慢性滑膜炎脂肪增生是同一种病不同的表现。

Study on MRI-pathologic in lipoma arborescens and chronic synovitis adipose hyperplasia of knee joint

Objective:To investigate the typical MRI features of lipoma arborescens (LA) of the knee, this paper compares and analyzes it with chronic synovitis lipohypertrophyofimagingandpathologyresults.Materials and Methods:Retrospective analysis was performed in 14 cases including 4 cases with LA proved by pathological diagnosis and 10 with chronic synovitis lipohypertrophy with datas of MRI and pathology. Lesionectomy was performed in all patients and specimen were observed in HE staining. Results:Four of 14 cases were diagnosed with LA. The adipose tissue by which characterized“tufted”,“dendritic”or“fluffy”, mild synovial hyperplasia as well, were revealed by the MRI and pathologic results. Two cases can not only see clusters of mature adipocyte, but also scattered ones. The others diagnosed with chronic synovitis adipose hyperplasia, both in MRI and pathology, showed synovial hyperplasia obviously and adipose tissue with only a few scattered flocculent point, while one with less adipose tissue even could not be found. Coexisting osteoarthritis was seen in all cases. Conclusions:MRI and pathologic performances of LA and hronic synovitis adipose hyperplasia show diffuse fatty infiltration of the subsynovial connective tissue. They differ in the form and content of synovial fat. Meanwhile we considered LA to be a manifestation or evolution in different stage of chronic synovitis adipose hyperplasia.