膝关节色素沉着绒毛结节性滑膜炎的MRI诊断及鉴别诊断

目的探讨膝关节色素沉着绒毛结节性滑膜炎(PVNS)的MRI诊断价值。方法回顾性分析18例经手术、病理确诊为色素沉着绒毛结节性滑膜炎的影像学资料。结果 X线表现:8例未见异常,10例显示关节囊肿胀,其中4例显示关节周围软组织内结节状密度增高影。关节间隙增宽5例,变窄3例。3例可见局部骨质缺损,边缘有硬化。MRI表现:弥漫型14例,局灶型4例。14例滑膜不同程度弥漫增厚及关节囊积液,关节囊内及周围多发大小不等结节状等及长T1信号影、短T2信号影,T2脂肪抑制结节呈低信号。10例关节面下见小结节状囊变灶。4例显示关节囊内局限结节状以等及长T1信号影、短T2为主不均信号影,T2脂肪抑制结节呈低信号。2例位于髌上囊,2例位于髌下囊。3例显示关节腔少量积液。结论 MRI对膝关节色素沉着绒毛结节性滑膜炎的诊断具有特征性,可以作为首选影像学检查。

Pigmented villonodular synovitis of knee joint in MRI diagnosis and differential diagnosis

Objective To evaluate the diagnostic value of MRI in pigmented villonodular synovitis of knee joint. Methods A retrospective analysis about imaging data of 18 patients was carried out from March 2009 to November 2012, which were conformed by surgical and pathological for pigmented villonodular synovitis. Results X-ray findings., eight cases were normal. 10 cases of joint capsule swelling, including four cases of articular soft tissue nodular density increased shadow. 5 cases were the widening of the joint space and narrowing o[ 3 cases. 3 cases visible local bone defects, edge hardened. （2） MRI findings.. 14 cases were diffuse type and 4cases were focal type. 14 cases of The synovial different degree of diffuse thickening of the joint capsule effusion, intraarticular and around multiple nodules of varying sizes long T1 signal intensity, short-T2 signal, T2 fat suppression nodules showed low signal. Small nodular cystic tumor were in 10 patients with articular surface. 4 cases showed the joint capsule limitations nodular main uneven signal intensity and other long T1 signal intensity, short T2 and T2 fat suppression nodules showed low signal. Two eases in patellar bursa, and two cases in infrapatellar bursa. Intra-articular effusion were in 3 cases. Conclusion MRI diagnosis of knee pigmented villonodular synovitis is characteristic, it can be as preferred imaging method.