膝关节色素沉着绒毛结节性滑膜炎的超声表现与病理变化关系

目的:探讨膝关节色素沉着绒毛结节性滑膜炎(PVNS)的超声表现与病理变化的关系,评价超声诊断PVNS的临床价值。材料和方法:回顾性分析19例膝关节PVNS的超声表现,并与手术病理结果对照。结果:19例PVNS均为弥漫型,病理特征为滑膜增厚呈结节状或绒毛状,有丰富的血管和大量含铁血黄素沉着;超声显示病变关节内有不同程度积液;滑膜增厚并有结节状隆起或互相形成较大肿块,其回声为低、中或高回声;CDFI示滑膜内均可见较丰富血流信号;部分可见骨质及周围组织侵蚀性改变。结论:超声诊断PVNS有一定的应用价值,可作为首选筛检方法。

Pigmented Villonodular Synovitis of the Knee: The Correlated Ultrasonography Manifestation and Pathologic Changes

Purpose: In order to better understand its clinical significance, the ultrasonographic features of pigmented villonodular synovitis (PVNS) of knee joints were analyzed and compared with the underlined pathologic change. Materials and Methods: Ultrasonography of the knee joints in 19 cases with PVNS were retrospectively studied in comparison with surgical and pathological findings. Results: 19 cases of PVNS had diffuse form of synovitis. The fundamental pathological alteration were idiopathic proliferation of synovial tissue and deposition of hemosiderin within villondules; The proliferation of synovial tissue and effusion in the joints were clearly visualized by the ultrasonography. Sonograms also revealed the nodular masses with varied echogenicity. An extensive blood signal could be detected in the proliferated synovium. In some cases, destruction of the bone, cartilage and surrounding tissues could be detected. Conclusion: Ultrasonography is able to reveal fundamental pathological alteration of synovium proliferation in PVNS.