颞下颌关节滑膜软骨瘤病的影像诊断

目的对颞下颌关节滑膜软骨瘤病的临床、影像、病理学进行综合分析,提高对该病的认识。方法对8例具有完整病例资料并经手术病理证实的颞下颌关节滑膜软骨瘤病患者的临床资料、影像学征象及病理改变进行总结。结果临床表现:8例患者均有耳前区疼痛、肿胀伴张口受限,术中见关节腔内大量游离体。影像学表现:X线示颞下颌关节间隙增宽、髁突周围多发不透亮区;CT示关节腔内软组织密度影伴周围多发钙化,4例见骨质破坏;MR示关节腔内软组织肿块伴积液,周围多发长T_1WI、短T_2WI信号,增强后呈不均匀强化,动态增强扫描时间-信号强度变化曲线呈平坦型。病理表现:关节腔内游离体由透明软骨构成,伴周围纤维化、钙化。电镜下见大量透明软骨细胞覆盖以成纤维样滑膜细胞。结论颞下颌关节滑膜软骨瘤病具有典型的临床、影像及病理特点。

Radiological diagnosis of synovial chondromatosis of temporomandibular joint

Objective To study the clinical, radiological and pathological features of synovial chondromatosis of temporo-mandibular joints (TMJ). Methods The clinical records,.radiological manifestation and pathological features of 8 patients with surgically confirmed synovial chondromatosis of TMJ were reviewed. Results All patients presented with pain and swelling of preauricular regions with limitation of mouth opening. Radiographs showed widened joint spaces with calcifications (8). Soft tissue masses with calcifications around the TMJ (8) and bone destruction (4) were seen on CT. The soft tissue masses were T1 and T2 hypointense peripherally with heterogeneous contrast enhancement,.flat dynamic contrast enhancement curves and joint effusion on MRI (8). A large number of loose bodies were seen in the TMJ at surgery. The loose bodies were composed of cartilage with fibrosis and calcification..Under electron microscopy,a large number of transparent chondrocytes were covered by fibroblast -like synoviocytes. Conclusion Synovial chondromatosis of TMJ has typical clinical, radiological and pathological features.