MRI在色素沉着绒毛结节性滑膜炎术前诊断应用

目的探讨MRI在色素沉着绒毛结节性滑膜炎(PVNS)术前诊断应用。方法回顾性分析2009年3月-2015年10月我院收治的经手术病理证实的50例PVNS患者的临床资料,均行MRI及CT检查,分析所有病例患者术前MRI及CT影像表现,以评估MRI在PVNS术前中的诊断应用价值。结果 MRI对PVNS的检出率均较CT的检出率显著高,均具有统计学意义(P0.05);50例患者中弥漫型、局限型例数分别为46、4例,均可见大小不一的关节积液,呈长T1、T2信号;46例弥漫型可见患者关节囊壁滑膜不同程度增厚,且伴有多发大小不一软组织结节;其中膝关节(2例)和踝部小关节(2例)为局限型,表现为局部单一类圆形及不规则型结节;而增厚滑膜及其结节表现为T1WI低或等信号,T2WI低信号并夹杂低高混杂信号,滑膜呈不同程度增厚,其中18例髌上囊滑膜边缘表现为波浪状改变,7例髌下脂肪囊表现为结节状及条状异常信号,5例前后交叉韧带区表现为高低混杂信号影;30例以关节面骨质凹陷缺损为主要表现,而其信号与滑膜相同;46例关节邻近骨髓内提示反应性水肿信号,并呈片状不规则及T2加权高信号,4例增强扫描可见增厚滑膜及明显强化的结节。结论 MRI在PVNS术前诊断中影像学表现具有一定特异性,MRI可作为PVNS术前诊断的重要手段。

Application of MRI in Preoperative Diagnosis of Pigmented Villonodular Synovitis

Objective To explore application of MRI in preoperative diagnosis of pigmented villonodular synovitis (PVNS).Methods A retrospective analysis of clinical data was carried out in 50 PVNS patients treated in our hospital from March 2009 to October 2015 confirmed by operation and pathology,all patients underwent MRI and CT,preoperative MRI and CT imaging features of all patients were analyzed to estimate diagnostic value of MRI in preoperative PVNS.Results Detection rate of MRI to arthroedema,nodule and mass of soft tissue,synovial thickening,hemosiderosis were significandy higher than CT (P＜0.05),46 patients were diffuse type,4 patients were topical type in 50 patients,hydrops articuli in different sizes could be seen,main behaviors were T1,T2 long signal,synovial membrane of articular capsule in different degrees uneven thickening could be seen in 46 patients in diffuse type,with soft tissue nodes in inequality of size,2 cases of knee-joint and 2 cases of ankle joint were topical type,local single type circular and irregular nodules could be seen,thickened synovium and synovial nodule were low or equal signal in T1WI,most low high mixed signal were low signal in T2WI,synovium were uneven thickening,18 cases of bursae suprapatellaris synovium edge were waved changes,nodositas and strip abnormal signal could be seen in 7 cases of inffapatellar capsula renis,high and low mixed signal could be seen in 5 cases of anterior and anterior cruciate ligament,arthrodial cartilage and cartilage destruction could be seen in 30 cases,main performances were defects and sunken in articular surface,signal in defect area was consistent with synovium,reactiveness edema signal could be seen in 46 cases of periarticular marrow,showed lamellar irregular T2 weighted high signal,4 cases enhancement scanning prompted that thickened synovium and tuberculum were obvious strengthening.Conclusion MRI imaging features has characteristics in preoperative diagnosis of PVNS,MRI can be used as one important method to preoperative diagnosis of PVNS.