膝关节树枝状脂肪瘤一例

患者女,16岁。以左膝关节肿痛10余年为主诉入院,10余年前,患者摔倒后出现左膝关节疼痛伴红肿,自服中药后,疼痛减轻,之后间断出现左膝关节红肿、疼痛,整个病程中无发热、皮疹,无双手关节疼痛,无腰痛、足跟痛。入     

膝关节滑膜树枝状脂肪瘤的MRI表现

目的：探讨膝关节滑膜树枝状脂肪瘤（LA）的MRI表现,并与术后病理对照,加强对该病的认识。方法：回顾性分析7例经手术病理确诊的LA,均行MRI检查,其中2例行关节镜检查,分析其MRI特征性表现。结果：7例病变均位于髌上囊,MRI示：4例表现为树枝状病灶,呈伪足征;2例表现为髌上囊后部棉团状病变,边缘呈浅分叶,可见宽基底附着于髌上囊;1例表现为髌上囊弥漫分布沙砾状小结节游离体,伴大量积液。T₁WI、T₂WI均呈高信号,脂肪抑制序列呈低信号,病理示大量脂肪细胞。结论：LA的MRI表现具有一定特征性,能帮助临床术前明确诊断。     

膝关节滑膜树枝状脂肪瘤1例

患者 男,42岁,主诉右膝关节肿痛2年余,曾于2012-10在当地医院就诊,诊断为滑膜炎。给予抽液,冲洗,抗生素等治疗,症状得到缓解。本次由于胀痛症状再次出现,来院就诊。入院查体：中等体型,无膝关节外伤史。右膝关节较对侧明显肿胀,有压痛,局部皮温高,浮髌实验阳性,关节活动受限。实验室检查：血、尿、便常规及血尿酸正常,血沉、类风湿3项、C反应蛋白均在正常值范围。MRI 检查显示：膝关节腔及髌上囊内可见大量积液,积液内可见多发 T1 WI 序列呈高信号,脂肪抑制 T2 WI 序列呈低信号,树枝状、绒毛状结节(图1~4)。行右膝关节关节镜滑膜切除,术后病理诊断为：滑膜树枝状脂肪瘤。     

膝关节树枝状脂肪瘤的MRI诊断

目的 探讨MRI对膝关节树枝状脂肪瘤(LA)的诊断价值.方法 回顾性分析5例经手术及病理证实为LA的MRI表现.所有患者均行MR平扫,其中1例同时行增强扫描.结果 5例均位于髌上囊.MR显示4例髌上囊滑膜明显增厚,呈"棕榈叶状"改变,1例髌上囊滑膜 "绒毛状"轻度增厚,明显强化;增厚的滑膜T1WI上表现为高信号、T2WI上表现为稍高信号,脂肪抑制序列上表现为低信号,梯度回波序列上表现为高、低混杂信号;5例髌上囊大量积液,2例滑膜囊内多发游离体;5例髌软骨均轻度损伤;1例胫骨平台外侧部滑膜囊肿.结论 膝关节LA具有特征性MR表现,术前MRI能对其定性诊断.     

膝关节树枝状脂肪瘤与色素沉着绒毛结节滑膜炎的MRI表现

目的：对比分析膝关节树枝状脂肪瘤与色素沉着绒毛结节滑膜炎的MRI征象,探讨其MRI诊断及鉴别诊断价值。方法：回顾性分析5例膝关节树枝状脂肪瘤与10例色素沉着绒毛结节滑膜炎的临床及MRI资料。结果：5例树枝状脂肪瘤MRI表现为树枝状、海草样增生的滑膜,可见与皮下脂肪信号一致的成熟脂肪组织信号,同时可伴关节面软骨及软骨下骨损伤、关节滑膜囊积液等其他征象。10例色素沉着绒毛结节滑膜炎主要表现为增生的滑膜内出现绒毛状或结节状增生,T₁WI呈等或低信号、T₂WI呈低信号,其内可见含铁血黄素沉积,关节滑膜腔内外均可累及,具有一定侵袭性。结论：MRI能直接显示滑膜病变形态及范围,通过增生滑膜内脂肪成分与含铁血黄素MRI信号的差异,以及色素沉着绒毛结节滑膜炎有跨关节滑膜囊内外生长的侵袭性生长特性,可明确诊断。     

膝关节滑膜树枝状脂肪瘤的MRI与病理对照分析

目的 探讨膝关节滑膜树枝状脂肪瘤(SLA)的MRI表现及与病理表现的对应关系,提高认识和诊断水平.方法 对22例(23个膝关节)经病理证实的膝关节SLA患者的MRI资料进行回顾性分析.结果 23个膝关节病灶均累及髌上囊,并可同时累及关节囊其他部位,增厚的滑膜呈“棕榈叶”状或“团块”状向关节腔突起,其信号可分为2种类型:Ⅰ型39个病灶,突起滑膜呈脂肪信号(T1WI高、T2WI稍高信号,抑脂扫描信号抑制),边缘强化,病理检查证实滑膜下大量成熟脂肪细胞;Ⅱ型14个病灶,呈非脂肪信号(T1WI呈中等稍低信号,T2WI呈中等稍高信号,抑脂扫描信号无抑制),增强扫描明显强化,病理证实滑膜下无脂肪浸润.结论 膝关节SLA具有特征性的MRI表现,反映了其病理特征.     

肝脏血管平滑肌脂肪瘤的CT影像表现

目的探讨分析肝脏血管平滑肌脂肪瘤（angiomyolipoma,AML）CT表现及特征。方法回顾性分析8例经手术病理证实,且均进行了CT检查的肝脏AML患者资料。结果8例肝脏AML中脂瘤型1例,以脂肪成分为主,CT显示大片脂肪密度;血管瘤型2例,以血管成分为主,CT增强动脉期明显强化;肌瘤型1例,主要是由平滑肌成分组成,平扫密度均匀,增强呈均一或不均匀强化;混合型4例,三种成分含量相似,增强扫描呈不均匀强化。结论不同病理类型的肝脏AML的CT表现有所不同,CT检查可以清晰的显示出肿瘤的影像特征,了解肝脏AML的病理类型与CT表现之间的关系,有助于提高肝脏AML的cT诊断率。     

何为膝关节树枝状脂肪瘤？其主要症状及X线表现如何？应与何病鉴别？

何为膝关节树枝状脂肪瘤？其主要症状及Ｘ线表现如何？应与何病鉴别？树枝状脂肪瘤是１９８９年英国Ａｒｍｓｔｒｏｎｇ报道的１例，在此之前已有１２例报道。本病属于罕见的关节内病变，是由滑膜下堆集的脂肪和集结的肿胀绒毛突出物构成。在组织学上不能与其它滑膜下堆集...     

膝关节树枝状脂肪瘤的MRI征象分析及其与骨性关节炎关系的探讨

目的 研究膝关节树枝状脂肪瘤(LA)的典型MRI表现以及伴随病变,并探讨其与骨性关节炎的关系.方法 回顾性分析13例LA患者的膝关节(n=15) MRI图像,其中2个膝关节为病理证实,其余13个膝关节有典型MRI表现诊断.所有患者均行MR平扫,其中1例行增强扫描.结果 全部病例均累及髌上囊,其中3例同时蔓延至关节周围滑膜,MR表现为滑膜呈“树叶”状、“树枝”状、“绒毛”状增厚,T1WI序列上为高信号、T2 WI序列上为稍高信号,脂肪抑制序列上呈低信号,1例增强后滑膜呈明显强化.其中局灶结节型6.7％ (1/15),弥漫型53.3％ (8/15),混合型40.0％ (6/15).15个受累膝关节均伴关节积液;其中93.3％(14/15)伴骨性关节炎改变;40.0％ (6/15)伴半月板损伤;26.7％ (4/15)伴滑膜囊肿;20.0％(3/15)伴关节旁滑膜增厚;6.7％ (1/15)伴滑膜骨软骨瘤病.结论 膝关节LA在MRI上有特征性的形态信号改变,LA是引起骨性关节炎的因素之一.     

Lipoma arborescens of the glenohumeral joint: a possible cause of osteoarthritis

Lipoma arborescens is a very rare intra-articular lesion characterized by villous lipomatous proliferation of the synovium, usually involving the knee joint. To date, in the literature, there has been only one reported case of lipoma arborescens in the glenohumeral joint. But, the authors treated the patient conservatively and reported only the magnetic resonance imaging (MRI) findings. We report a case of a patient with lipoma arborescens involving the glenohumeral joint. To our knowledge, this is the first reported case of lipoma arborescens involving the glenohumeral joint managed by arthroscopic synovectomy. We identified reactive bone erosions and arthritic changes in the humeral head in a 22-year-old male patient by arthroscopy.     

Bilateral lipoma arborescens of the knee in a child: a case report

We report a case of childhood lipoma arborescens of both knee joints who had been erroneously diagnosed to have initially acute rheumatic fever and subsequently oligoarticular juvenile rheumatoid arthritis. She had taken anti-inflammatory medication for 8 years without remission of the effusion. Magnetic resonance imaging (MRI) and synovectomy revealed the diagnosis of lipoma arborescens. Lipoma arborescens should be kept in mind in the differential diagnosis of refractory chronic joint effusion and synovial hypertrophy in the childhood period, and MRI yields the correct diagnosis in this setting.     

Meniscal hematoma of the knee joint: a case report

We report here an unusual case of medial meniscal hematoma of the knee joint. A review of the literature has revealed only one case that was previously reported. The authors present the successful decompression of the posterior horn of a medial meniscal hematoma through the direct posterior–posterior triangulation arthroscopic visualization method. We present here the case report.     

膝关节色素沉着绒毛结节性滑膜炎1例

患者男性，35岁。右膝关节肿胀，疼痛多年，近期加重。查体：右膝明显肿胀。关节活动受限，右膝内侧上方及Guo徊窝处均可扪及大小不等的软组织肿块．边界不清．无压痛，有软韧感。关节穿刺见血性积液。     

Lipoma arborescens of the glenohumeral joint causing bone erosion: MRI features with gadolinium enhancement

Lipoma arborescens is a rare benign intra-articular lesion that principally affects the knee joint. We present a case of lipoma arborescens involving the glenohumeral joint and associated with prominent large bony erosions. The gadolinium diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI) features of this lesion are also described. The characteristic MRI findings permit precise preoperative diagnosis of this rare condition even if it occurs in an atypical location and there are confusing radiological findings.     

Lipoma arborescens of the peroneal tendon sheath

Lipoma arborescens or synovial lipomatosis is a rare disorder characterized by mature fat infiltration of hypertrophic synovial villi, most frequently affecting the suprapatellar pouch of the knee. Involvement of the synovial tendon sheath is extremely rare with only a few reported cases in the literature. We present a case of lipoma arborescens involving the peroneal and flexor tendons sheaths of the ankle, review the few reported cases to date, and discuss MR imaging features of this rare entity.