滑膜血管瘤的影像学诊断

目的:分析滑膜血管瘤的影像学表现及诊断价值。材料和方法:回顾性分析已确诊12例滑膜血管瘤(男性7例,女性5例),其中膝关节5例、肘关节2例、腕关节2例、髋关节2例、肩关节1例。X线检查8例,CT检查平扫2例,MRI检查5例其中增强4例,血管造影1例。结果:X线平片可以出现静脉石、软组织肿胀、骨质侵蚀、继发骨关节炎表现。CT表现为软组织肿胀及骨质侵蚀,血管造影仅发现膝周少许异常染色血管影。MRI发现局限型(2例)和弥漫型(3例),局限型表现为髌上囊区局限肿块影,T1WI上等低信号影,于T2WI序列表现为高信号;弥漫型2例表现为弥漫性生长可突破关节囊,病灶大部分呈T1WI上等低信号影,T2WI上高信号影,其内含有更低信号细条索影及高信号分隔影。1例含有大量含铁血黄素则T1WI及T2WI上均表现为低信号。结论:X线平片、CT及血管造影对滑膜血管瘤诊断有一定帮助,MRI可明确显示血管瘤特征性脉管及纤维脂肪成分,提高该病术前诊断率。

Imaging Diagnosis of Synovial Hemangioma

Purpose:To analyze the imaging characteristics and the diagnostic value of synovial hemangioma.Materials and Methods:12 cases(7 males,5 females)had been confirmed by pathology,involving the knee(n=5),elbow(n=2),wrist(n=2),shoulder(n=1)and hip(n=2).We retrospectively examined the imaging studies performed in these patients,including plain radiography(n=8),angiography(n=1),computed tomography(CT,n=2),magnetic resonance imaging(MRI,n=5).Results:Plain films showed phleboliths,joint effusion,bone erosions,and retrogression osteoarthritis.Neither angiography nor CT yielded specific findings.MRI showed localized lesions(2 cases)and diffuse lesions(3 cases).2 cases of localized lesions showed intra-articular well-circumscribed masses of intermediate signal intensity on Tl-weighted images and of high signal intensity on T2-weighted images.2 cases of diffuse lesions showed intra-articular and extra-articular diffuse masses of intermediate signal intensity on Tl-weighted images and of high signal intensity on T2-weighted images.1 cases of diffuse lesions showed low signal intensity on both Tl-weighted and T2-weighted.Thin fibrofatty septa within the lesion,frequently serpentine in appearance,were also observed in all patients.Gadolinium enhancement,used in 4 cases,revealed a heterogenous-appearing mass.Conclusion:Plain films,arthrography and CT are helpful for the diagnosis of synovial hemangioma.MRI could suggest the correct diagnosis of synovial hemangioma preoperatively.